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Biomass and Lung Cancer Update

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Biomass and Lung Cancer Update PowerPoint Presentation

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Published on : Feb 24, 2014
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Slide 1 - Household use of biomass and lung cancers INTERIM RESULTS Imran Choudhury, Dan Pope, Mukesh Dherani, Nigel Bruce University of Liverpool & Amir Sapkota University of Maryland
Slide 2 - Search strategy (Lung OR pulmonary OR bronchogenic OR bronchial OR “respiratory tract” OR bronch* OR trachea* OR “lower respiratory tract” ) Cancer OR cancers OR carcinoma OR carcinomata OR neoplasm OR neoplasms OR tumor OR tumors OR tumour OR tumours OR “*small-cell”)  "IAP" OR "Indoor air" OR "pollution" OR "pollutant" OR "fuel" OR "fuels" OR "dung" OR "agricultural waste" OR "crop waste" OR "crop residue" OR "charcoal" OR "coal" OR "biomass" OR "wood" OR "stove" OR "stoves" OR "chula" OR "chulla" OR "oven" OR "ovens" OR "smoke" OR "smoky" OR heat* OR cook* OR light* OR burn*
Slide 3 - Databases PubMed (Medline) Embase (Scopus & Ovid) Cochrane Controlled Trials Register CINAHL (Ovid) Global Health (Ovid) DARE (Database of Abstracts of Reviews of Effects) – for reviews LILACS (Latin American and Caribbean literature) Scielo Index Medicus Africanus Chinese databases CNKI – by Ray Liu @UCB
Slide 4 - Search results (English) 19,833 search results 137 papers: full papers (English) or foreign language paper abstracts with solid fuel data 60 potentially relevant for biomass review 25 Chinese abstracts/full papers for Ray 4 on request /awaiting translation 17 papers with some form relevant data
Slide 5 - Search Results Of the 17 papers which have data All case control studies 6 combine biomass with another fuel 11 papers with estimates for meta-analysis 1/11 later excluded
Slide 6 - Excluded from meta-analysis
Slide 7 - Included Studies
Slide 8 - Biomass specific exposure
Slide 9 - Subjects and Outcome Measures
Slide 10 - Quality Issues
Slide 11 - Quality Issues
Slide 12 - All studies (n=10)
Slide 13 - Publication bias Begg's Test adj. Kendall's Score (P-Q) = 22 Std. Dev. of Score = 24.28 Number of Studies = 17 z = 0.91 Pr > |z| = 0.365 z = 0.87 (continuity corrected) Pr > |z| = 0.387 (continuity corrected)   Egger's test ------------------------------------------------------------------------------ Std_Eff | Coef. Std. Err. t P>|t| [95% Conf. Interval] -------------+---------------------------------------------------------- -------------+------ slope | .0722589 .173642 0.42 0.683 -.2978503 .442368 bias | .4820188 .6609868 0.73 0.477 -.9268412 1.890879
Slide 14 - Biomass vs. clean fuel (n=8)
Slide 15 - Biomass vs. Clean fuel – excluding weaker studies n=5
Slide 16 - Key assumptions/issues Unclear reference categories Ever wood vs. never wood Cooking as exposure when most of subjects are men Studies with very low population prevalence of biomass use Is there a separate pathway for adenocarcinoma?
Slide 17 - Issues Comparable - probably Valid – a lot of quality issues even before considering ventilation, behaviour etc External validity might help?? Heterogeneity Meta-analysis does not give clear answer Probably need better data? Await Chinese studies
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