ets exposure, lung cancer - Legacy Tobacco Documents Library

the Fontham, et al ., study were adenocarcinomas . Alcohol
consumption, another potential confounder, was also not
mentioned . Recent studies have reported that smokers, and the
persons living in their households, are likely to consume more
fatty foods and more alcohol .
• The presentation in the Fontham, et al ., study does not
provide data for the possible associations between diet and
other potential confounders and lung cancer . It is thus
impossible to judge whether fruit and vegetable consumption
was associated with lung cancer risk but not with smoking
status, or with smoking status but not with lung cancer risk .
The reader must take the authors' position that the factors
were not confounders at face value, without the opportunity to
examine the data .
• The "adjustment" of the reported risk estimates is difficult
http://legacy.library.ucsf.edu/tid/wyk81f00/pdf
to interpret, as the adjustments take into account both study
design variables (e .g ., subject age) and potential
confounders . It is not possible to determine what might be
affecting the adjustment . In particular, the dramatic upward
shift (1 .12 to 1 .39) in the risk estimate for workplace ~~
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exposure is puzzling and surprising . The shift is opposite N
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the direction expected, and is of a magnitude unlike the other ~
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adjustments in the paper. ~
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