Walsh Linda, Schneider Uwe
Federal Office for Radiation Protection, Department of Radiation Protection and Health, Ingolstädter Landstr. 1, 85764 Oberschleissheim, Germany.
Radiat Environ Biophys. 2013 Mar;52(1):135-45. doi: 10.1007/s00411-012-0441-x. Epub 2012 Nov 20.
Radiation-related risks of cancer can be transported from one population to another population at risk, for the purpose of calculating lifetime risks from radiation exposure. Transfer via excess relative risks (ERR) or excess absolute risks (EAR) or a mixture of both (i.e., from the life span study (LSS) of Japanese atomic bomb survivors) has been done in the past based on qualitative weighting. Consequently, the values of the weights applied and the method of application of the weights (i.e., as additive or geometric weighted means) have varied both between reports produced at different times by the same regulatory body and also between reports produced at similar times by different regulatory bodies. Since the gender and age patterns are often markedly different between EAR and ERR models, it is useful to have an evidence-based method for determining the relative goodness of fit of such models to the data. This paper identifies a method, using Akaike model weights, which could aid expert judgment and be applied to help to achieve consistency of approach and quantitative evidence-based results in future health risk assessments. The results of applying this method to recent LSS cancer incidence models are that the relative EAR weighting by cancer solid cancer site, on a scale of 0-1, is zero for breast and colon, 0.02 for all solid, 0.03 for lung, 0.08 for liver, 0.15 for thyroid, 0.18 for bladder and 0.93 for stomach. The EAR weighting for female breast cancer increases from 0 to 0.3, if a generally observed change in the trend between female age-specific breast cancer incidence rates and attained age, associated with menopause, is accounted for in the EAR model. Application of this method to preferred models from a study of multi-model inference from many models fitted to the LSS leukemia mortality data, results in an EAR weighting of 0. From these results it can be seen that lifetime risk transfer is most highly weighted by EAR only for stomach cancer. However, the generalization and interpretation of radiation effect estimates based on the LSS cancer data, when projected to other populations, are particularly uncertain if considerable differences exist between site-specific baseline rates in the LSS and the other populations of interest. Definitive conclusions, regarding the appropriate method for transporting cancer risks, are limited by a lack of knowledge in several areas including unknown factors and uncertainties in biological mechanisms and genetic and environmental risk factors for carcinogenesis; uncertainties in radiation dosimetry; and insufficient statistical power and/or incomplete follow-up in data from radio-epidemiological studies.
为了计算辐射暴露的终生风险,与辐射相关的癌症风险可以从一个人群转移到另一个有风险的人群。过去曾基于定性加权,通过超额相对风险(ERR)或超额绝对风险(EAR)或两者混合(即来自日本原子弹幸存者的寿命研究(LSS))进行转移。因此,应用的权重值和权重的应用方法(即作为加法或几何加权平均值)在同一监管机构在不同时间产生的报告之间以及不同监管机构在相似时间产生的报告之间都有所不同。由于EAR和ERR模型之间的性别和年龄模式通常明显不同,因此需要一种基于证据的方法来确定此类模型与数据的相对拟合优度。本文确定了一种使用赤池模型权重的方法,该方法可以帮助专家判断,并应用于在未来的健康风险评估中帮助实现方法的一致性和基于定量证据的结果。将该方法应用于最近的LSS癌症发病率模型的结果是,按实体癌部位的相对EAR加权,在0 - 1的范围内,乳腺癌和结肠癌为零,所有实体癌为0.02,肺癌为0.03,肝癌为0.08,甲状腺癌为0.15,膀胱癌为0.18,胃癌为0.93。如果在EAR模型中考虑到女性特定年龄乳腺癌发病率与达到年龄之间普遍观察到的与更年期相关的趋势变化,女性乳腺癌的EAR加权从0增加到0.3。将该方法应用于对拟合LSS白血病死亡率数据的许多模型进行多模型推断研究中的首选模型,结果EAR加权为0。从这些结果可以看出,仅对于胃癌,终生风险转移在EAR中权重最高。然而,如果LSS中特定部位的基线率与其他感兴趣人群之间存在相当大的差异,那么将基于LSS癌症数据的辐射效应估计值推广到其他人群并进行解释时,就会特别不确定。关于转移癌症风险的适当方法的明确结论受到几个领域知识缺乏的限制,包括致癌生物学机制、遗传和环境风险因素中的未知因素和不确定性;辐射剂量学中的不确定性;以及放射流行病学研究数据中统计能力不足和/或随访不完整。