Gulf War and Health: Volume 2: Insecticides and Solvents (2003)

Chapter: Appendix E: Relative Risks for Lung Cancer

Previous Chapter: Appendix D: Insecticides and Solvents Sent to the Gulf War
Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.

E
RELATIVE RISKS FOR LUNG CANCER

Table E.1 shows detailed results1 under certain assumptions of the prevalence of smoking in the general population and in the occupational cohort. Some of the scenarios are rather implausible, for example, assuming that 70% of the population is heavy smokers. In cases where the prevalence of smoking in the general population exceeds that of the cohort, the expected relative risks are less than unity, meaning that an observed excess relative risk in the cohort would be underestimated because of confounding by smoking. Expected relative risks greater than unity, as would occur when there are more and heavier smokers in the occupational cohort, are interpreted as meaning that some of an observed effect could be explained by smoking. In the instance where all cohort members smoke heavily, the maximum relative risk that could be observed is 3.1. In general, the table shows that one requires extreme differential smoking patterns to explain observed relative risks above 1.5.

The expected relative risks for lung cancer due solely to smoking presented below. Table E.1 was calculated assuming a relative risk for “moderate” smoking of 10 and for “heavy” smoking of 20.

TABLE E.1 Relative Risks for Lung Cancer

General Population

40% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

1.0

50

10

1.1

60

10

1.3

70

10

1.4

30

20

1.2

40

20

1.3

50

20

1.4

60

20

1.6

20

30

1.3

30

30

1.4

40

30

1.6

50

30

1.7

10

40

1.5

10

50

1.8

10

60

2.0

10

70

2.3

General Population

50% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.9

50

10

1.0

60

10

1.1

70

10

1.2

30

20

1.0

40

20

1.1

50

20

1.3

60

20

1.4

20

30

1.1

30

30

1.3

40

30

1.4

50

30

1.5

10

40

1.3

10

50

1.5

10

60

1.8

10

70

2.1

General Population

60% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.8

50

10

0.9

60

10

1.0

70

10

1.1

30

20

0.9

40

20

1.0

50

20

1.1

60

20

1.2

20

30

1.0

30

30

1.1

40

30

1.2

50

30

1.3

10

40

1.1

10

50

1.4

10

60

1.6

10

70

1.8

1  

Provided by Mark Goldberg, Ph.D.

Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.

General Population

70% Moderate and 10% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.7

50

10

0.8

60

10

0.9

70

10

1.0

30

20

0.8

40

20

0.9

50

20

1.0

60

20

1.1

20

30

0.9

30

30

1.0

40

30

1.1

50

30

1.2

10

40

1.0

10

50

1.2

10

60

1.4

10

70

1.7

General Population

30% Moderate and 20% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.9

50

10

1.0

60

10

1.1

70

10

1.2

30

20

1.0

40

20

1.1

50

20

1.2

60

20

1.4

20

30

1.1

30

30

1.3

40

30

1.4

50

30

1.5

10

40

1.3

10

50

1.5

10

60

1.8

10

70

2.0

General Population

40% Moderate and 20% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.8

50

10

0.9

60

10

1.0

70

10

1.1

30

20

0.9

40

20

1.0

50

20

1.1

60

20

1.2

20

30

1.0

30

30

1.1

40

30

1.2

50

30

1.3

10

40

1.1

10

50

1.4

10

60

1.6

10

70

1.8

General Population

50% Moderate and 20% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.7

50

10

0.8

60

10

0.9

70

10

1.0

30

20

0.8

40

20

0.9

50

20

1.0

60

20

1.1

20

30

0.9

30

30

1.0

40

30

1.1

50

30

1.2

10

40

1.0

10

50

1.2

10

60

1.4

10

70

1.6

General Population

60% Moderate and 20% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.6

50

10

0.7

60

10

0.8

70

10

0.9

30

20

0.7

40

20

0.8

50

20

0.9

60

20

1.0

20

30

0.8

30

30

0.9

40

30

1.0

50

30

1.1

10

40

0.9

10

50

1.1

10

60

1.3

10

70

1.5

General Population

20% Moderate and 30% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.8

50

10

0.9

60

10

1.0

70

10

1.1

30

20

0.9

40

20

1.0

50

20

1.1

60

20

1.2

20

30

1.0

30

30

1.1

40

30

1.2

50

30

1.3

10

40

1.1

10

50

1.3

10

60

1.6

10

70

1.8

Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.

General Population

30% Moderate and 30% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.7

50

10

0.8

60

10

0.9

70

10

1.0

30

20

0.8

40

20

0.9

50

20

1.0

60

20

1.1

20

30

0.9

30

30

1.0

40

30

1.1

50

30

1.2

10

40

1.0

10

50

1.2

10

60

1.4

10

70

1.6

General Population

40% Moderate and 30% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.6

50

10

0.7

60

10

0.8

70

10

0.9

30

20

0.7

40

20

0.8

50

20

0.9

60

20

1.0

20

30

0.8

30

30

0.9

40

30

1.0

50

30

1.1

10

40

0.9

10

50

1.1

10

60

1.3

10

70

1.5

General Population

50% Moderate and 30% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.6

50

10

0.7

60

10

0.7

70

10

0.8

30

20

0.7

40

20

0.8

50

20

0.8

60

20

0.9

20

30

0.8

30

30

0.8

40

30

0.9

50

30

1.0

10

40

0.8

10

50

1.0

10

60

1.2

10

70

1.4

General Population

10% Moderate and 40% Heavy

Moderate

(RR=10)

Heavy

(RR=20

Expected

RR

40

10

0.7

50

10

0.8

60

10

0.9

70

10

1.0

30

20

0.8

40

20

0.9

50

20

1.0

60

20

1.1

20

30

0.9

30

30

1.0

40

30

1.1

50

30

1.2

10

40

1.0

10

50

1.2

10

60

1.4

10

70

1.6

General Population

10% Moderate and 50% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.6

50

10

0.6

60

10

0.7

70

10

0.8

30

20

0.7

40

20

0.7

50

20

0.8

60

20

0.9

20

30

0.7

30

30

0.8

40

30

0.9

50

30

1.0

10

40

0.8

10

50

1.0

10

60

1.2

10

70

1.3

General Population

10% Moderate and 60% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.5

50

10

0.6

60

10

0.6

70

10

0.7

30

20

0.6

40

20

0.6

50

20

0.7

60

20

0.8

20

30

0.6

30

30

0.7

40

30

0.8

50

30

0.8

10

40

0.7

10

50

0.9

10

60

1.0

10

70

1.1

Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.

General Population

10% Moderate and 70% Heavy

Moderate

(RR=10)

Heavy

(RR=20)

Expected

RR

40

10

0.4

50

10

0.5

60

10

0.5

70

10

0.6

30

20

0.5

40

20

0.6

50

20

0.6

60

20

0.7

20

30

0.6

30

30

0.6

40

30

0.7

50

30

0.7

10

40

0.6

10

50

0.8

10

60

0.9

10

70

1.0

Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.
Page 570
Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.
Page 571
Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.
Page 572
Suggested Citation: "Appendix E: Relative Risks for Lung Cancer." Institute of Medicine. 2003. Gulf War and Health: Volume 2: Insecticides and Solvents. Washington, DC: The National Academies Press. doi: 10.17226/10628.
Page 573
Next Chapter: Appendix F: Neurologic Examination
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