International Journal of Medical Sciences

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22 November 2018

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Int J Med Sci 2009; 6(6):329-337. doi:10.7150/ijms.6.329

Research Paper

Comparative study of control selection in a national population -based case-control study: Estimating risk of smoking on cancer deaths in Chinese men

Jingmei Jiang1, Boqi Liu2 ✉, Philip C. Nasca3, Wei Han1, Xiaonong Zou2, Xianjia Zeng1, Xiaobing Tian1, Yanping Wu2, Ping Zhao2, Junyao Li2

1. Department of Epidemiology and Medical Statistics, Peking Union Medical College
2. Department of Epidemiology, National Cancer Institute, Chinese Academy of Medical Sciences
3. Department of Epidemiology and Biostatistics, SUNY, Albany, the USA


Purpose: To assess the validation of a novel control selection design by comparing the consistency between the new design and a routine design in a large case-control study that was incorporated into a nationwide mortality survey in China.

Methods: A nationwide mortality study was conducted during 1989-1991. Surviving spouses or other relatives of all adults who died during 1986-1988 provided detailed information about their own as well as the deceased person's smoking history. In this study, 130,079 males who died of various smoking-related cancers at age 35 or over were taken as cases, while 103,248 male surviving spouses (same age range with cases) of women who died during the same period and 49,331 males who died from causes other than those related to smoking were used as control group 1 and control group 2, respectively. Consistency in the results when comparing cases with each of the control groups was assessed.

Results: Consistency in the results was observed in the analyses using different control groups although cancer deaths varied with region and age. Equivalence could be ascertained using a 15% criterion in most cancer deaths which had high death rates in urban areas, but they were uncertain for most cancers in rural areas irrespective of whether the hypothesis testing showed significant differences or not.

Conclusions: Sex-matched living spouse control design as an alternative control selection for a case-control study is valid and feasible, and the basic principles of the equivalence study are also supported by epidemiological survey data.

Keywords: case-control studies, epidemiologic methods, comparative study, smoking, Chinese men.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Jiang J, Liu B, Nasca PC, Han W, Zou X, Zeng X, Tian X, Wu Y, Zhao P, Li J. Comparative study of control selection in a national population -based case-control study: Estimating risk of smoking on cancer deaths in Chinese men. Int J Med Sci 2009; 6(6):329-337. doi:10.7150/ijms.6.329. Available from