Question

Lung Cancer & Smoking Case Study

A causal relationship between cigarette smoking and lung cancer was first suspected in the 1920s on the basis of clinical observations. To test this apparent association, numerous epidemiologic studies were undertaken between 1930 and 1960. Two studies were conducted by Richard Doll and Austin Bradford Hill in Great Britain. The first was a case-control study begun in 1947 comparing the smoking habits of lung cancer patients with the smoking habits of other patients. The second was a cohort study begun in 1951 recording causes of death among British physicians in relation to smoking habits. This case study deals first with the case-control study, then with the cohort study. Data for the case-control study were obtained from hospitalized patients in London and vicinity over a 4-year period (April 1948 - February 1952). Initially, 20 hospitals, and later more, were asked to notify the investigators of all patients admitted with a new diagnosis of lung cancer. These patients were then interviewed concerning smoking habits, as were controls selected from patients with other disorders(primarily non-malignant) who were hospitalized in the same hospitals at the same time. Data for the cohort study were obtained from the population of all physicians listed in the British Medical Register who resided in England and Wales as of October 1951. Information about present and past smoking habits was obtained by questionnaire. Information about lung cancer came from death certificates and other mortality data recorded during the ensuing years.

3: Name three other sources where cases might have been found and three other sources where controls may have been found.

4: Give four (4) reasons as to why hospitals may have been chosen as the setting for this study.

Answer 1

3.The medical history of family physicians, health behavioural information, gender, age, ethnicity, economic status, medical insurance information, medical information of patients or participants randomly chosen from various healthcare settings are some of the other cases and controls that may have been used.

4.Time: It saves time to use hospitals, as inquiries do not have to look for controls and cases

Cost Effective: It will save people money from going to the hospital.

Accessibility: Patients in hospitals are more driven and access to information would also be easy for them.

Lower preference bias: It will help to minimise selection bias when choosing hospitals.