Boivin J F, Wacholder S
Département d'épidémiologie, Université McGill, Montréal.
Rev Epidemiol Sante Publique. 1988;36(4-5):292-300.
A paradoxical effect of radiotherapy and chemotherapy for cancer is that some of these treatments can themselves cause new cancers. Most epidemiologic methods can be applied successfully to the investigation of this problem and this paper reviews various approaches that have already been used by various researchers. The authors first review the more traditional methods, i.e., cohort and case-control studies and they then describe designs that have been proposed more recently, such as case-cohort studies. A distinction is established between internal comparisons, carried out within the study population, and external comparisons, in which a general population external to the population under study is used as the reference category. This presentation is mainly aimed at investigators using tumor registry data. However, the general principles formulated here are easily generalized to contexts other than that of registries.
放射疗法和化学疗法治疗癌症存在一种矛盾的效应，即这些治疗方法本身可能会引发新的癌症。大多数流行病学方法都能成功应用于该问题的调查，本文回顾了不同研究人员已经采用的各种方法。作者首先回顾了更为传统的方法，即队列研究和病例对照研究，然后描述了最近提出的设计，如病例队列研究。研究人群内部进行的内部比较与以研究人群之外的普通人群作为参照组的外部比较之间存在区别。本介绍主要针对使用肿瘤登记数据的研究人员。然而，这里阐述的一般原则很容易推广到登记处以外的其他情况。
