Becker N
German Cancer Research Center, Department of Epidemiology, Heidelberg.
Arch Environ Health. 1989 Jul-Aug;44(4):260-6. doi: 10.1080/00039896.1989.9935892.
Cumulative damage models are a special class of mathematical models within reliability theory that describe the probability of failure of a given system under the impact of a damaging environment. Though originally introduced to handle wear and tear processes, their concepts can easily be interpreted in terms of the epidemiologic aspects of human carcinogenesis. This paper introduces the new approach and demonstrates its applicability to human cancer incidence and mortality data from Denmark and the Federal Republic of Germany. A slight simplification of the originally stochastic model provides an explicit formula for the relative risk between different populations, which predicts that this basic measure used in cancer epidemiology may have to be considered age-dependent in contrast to a widely used practice which, for convenience, postulates age-independent relative risks. A comparison with empirical data reveals that the concept of age-dependent relative risks is not inconsistent with real world examples of cancer incidence. Thus, some basic assumptions and concepts of epidemiology concerning carcinogenesis and strategies for data analysis may require reconsideration.
累积损伤模型是可靠性理论中的一类特殊数学模型，用于描述给定系统在有害环境影响下的失效概率。尽管最初是为处理磨损过程而引入的，但其概念很容易从人类致癌作用的流行病学方面进行解释。本文介绍了这种新方法，并证明了其在丹麦和德意志联邦共和国人类癌症发病率和死亡率数据中的适用性。对原始随机模型进行轻微简化后，得到了不同人群之间相对风险的显式公式，该公式预测，与广泛采用的为方便起见假定相对风险与年龄无关的做法相反，癌症流行病学中使用的这一基本指标可能必须考虑与年龄有关。与经验数据的比较表明，与年龄有关的相对风险概念与癌症发病率的实际例子并不矛盾。因此，流行病学中一些关于致癌作用的基本假设和概念以及数据分析策略可能需要重新考虑。
