SynthesisJournal of the National Cancer Institute. Monographs2020
Evaluation of Confounding and Selection Bias in Epidemiological Studies of Populations Exposed to Low-Dose, High-Energy Photon Radiation.
Synthesis in Journal of the National Cancer Institute. Monographs, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Confounding and the healthy worker survivor effect in studies of medical radiation workers: a systematic review of methodological approaches.Epidemiology and health · 2026Pooled it
- Occupational Benzene Exposure and Lung Cancer in Human Studies: A Systematic Review and Meta-Analysis.Environmental health perspectives · 2024Pooled it
- Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Rationale and Framework for the Monograph and Overview of Eligible Studies.Journal of the National Cancer Institute. Monographs · 2020Pooled it
- Epidemiological Studies of Low-Dose Ionizing Radiation and Cancer: Summary Bias Assessment and Meta-Analysis.Journal of the National Cancer Institute. Monographs · 2020Pooled it
- Review
- Radiation Exposure and Cancer Mortality in Populations Living Around the Semipalatinsk Nuclear Test Site in Kazakhstan.International journal of environmental research and public health · 2026Article
- Comparison of radiation-related cancer risks from the atomic bomb survivors with studies of pediatric medical radiation exposure.Carcinogenesis · 2025Article
- Confounding Effects of Lifestyle Factors in Cancer Risk Estimation for Occupational Radiation Exposure.Safety and health at work · 2025Article
- Site-specific cancer mortality after low-level exposure to ionizing radiation: findings from an update of the International Nuclear Workers Study (INWORKS).American journal of epidemiology · 2025Article
- A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure.Radiation research · 2024Review
- A generalisation of the method of regression calibration and comparison with Bayesian and frequentist model averaging methods.Scientific reports · 2024Article
- Article
- A generalisation of the method of regression calibration and comparison with the Bayesian 2-dimensional Monte Carlo method.Research square · 2023Article
- A generalisation of the method of regression calibration.Scientific reports · 2023Article
- A generalisation of the method of regression calibration.Research square · 2023Article
- Cancer mortality after low dose exposure to ionising radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study.BMJ (Clinical research ed.) · 2023Article
- Ionizing radiation and solid cancer mortality among US nuclear facility workers.International journal of epidemiology · 2023Article
- Comparison of All Solid Cancer Mortality and Incidence Dose-Response in the Life Span Study of Atomic Bomb Survivors, 1958-2009.Radiation research · 2022Article
- Association Between Radioactive Iodine Treatment for Pediatric and Young Adulthood Differentiated Thyroid Cancer and Risk of Second Primary Malignancies.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Article
- Review of the risk of cancer following low and moderate doses of sparsely ionising radiation received in early life in groups with individually estimated doses.Environment international · 2022Review
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundLow-dose, penetrating photon radiation exposure is ubiquitous, yet our understanding of cancer risk at low doses and dose rates derives mainly from high-dose studies. Although a large number of low-dose cancer studies have been recently published, concern exists about the potential for confounding to distort findings. The aim of this study was to describe and assess the likely impact of confounding and selection bias within the context of a systematic review.
methodsWe summarized confounding control methods for 26 studies published from 2006 to 2017 by exposure setting (environmental, medical, or occupational) and identified confounders of potential concern. We used information from these and related studies to assess evidence for confounding and selection bias. For factors in which direct or indirect evidence of confounding was lacking for certain studies, we used a theoretical adjustment to determine whether uncontrolled confounding was likely to have affected the results.
resultsFor medical studies of childhood cancers, confounding by indication (CBI) was the main concern. Lifestyle-related factors were of primary concern for environmental and medical studies of adult cancers and for occupational studies. For occupational studies, other workplace exposures and healthy worker survivor bias were additionally of interest. For most of these factors, however, review of the direct and indirect evidence suggested that confounding was minimal. One study showed evidence of selection bias, and three occupational studies did not adjust for lifestyle or healthy worker survivor bias correlates. Theoretical adjustment for three factors (smoking and asbestos in occupational studies and CBI in childhood cancer studies) demonstrated that these were unlikely to explain positive study findings due to the rarity of exposure (eg, CBI) or the relatively weak association with the outcome (eg, smoking or asbestos and all cancers).
conclusionConfounding and selection bias are unlikely to explain the findings from most low-dose radiation epidemiology studies.
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