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Generalizability of Relative Risk Estimates from a Well-defined Population to a General Population

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Abstract

We investigated the degree of generalizability of relative risk (RR) estimates for a sample from a well-defined population to a general population using actual data. A total of 45,452 men aged 40–69 years who completed a self-administered questionnaire were followed from 1990–1994 to the end of 1999–2000 in the Japan Public Health Center-based Prospective Study. We considered those who responded to the self-administered questionnaire (45,452 men) as representing the general population (population), and those who underwent a health check-up as representing a sample from a well- defined population (sample) (12,162 men). Exposure distributions, mortality rates, and the confounder-adjusted RRs of all-cause mortality according to cigarette smoking or body mass index (BMI) were compared between the sample and the population using empirical sampling distributions from the population. The sample had significantly different prevalences of exposures and lower mortality rates than the population. Adjusted RRs were significantly higher in current smokers (RR = 1.83) and in subjects who smoked ≥40 cigarettes per day (RR = 2.67) in the sample than the respective values in the corresponding categories (RR = 1.48 and 1.62, respectively) of the population. The adjusted RR of those with the lowest BMI in the sample (RR = 1.30) were also significantly lower than those of the corresponding category in the population (RR = 2.06). Our results suggest that even for RRs, the extrapolation of estimates for a sample from a well-defined population to a general population may not be possible.

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Abbreviations

ASR:

Age-standardized mortality rate

BMI:

Body mass index

CI:

Confidence interval

PHC:

Public Health Center

RR:

Relative risk

the JPHC study:

The Japan Public Health Center-based Prospective Study

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Authors and Affiliations

  1. Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Motoki Iwasaki, Tetsuya Otani, Manami Inoue, Tomoyuki Hanaoka & Shoichiro Tsugane

  2. Statistics and Cancer Control Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo, Japan

    Seiichiro Yamamoto & Tomotaka Sobue

Authors
  1. Motoki Iwasaki
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  2. Seiichiro Yamamoto
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  3. Tetsuya Otani
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  4. Manami Inoue
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  5. Tomoyuki Hanaoka
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  6. Tomotaka Sobue
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  7. Shoichiro Tsugane
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Consortia

Japan Public Health Center-based Prospective Study (JPHC Study) Group

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Correspondence to Motoki Iwasaki.

Additional information

Japan Public Health Center-based Prospective Study (JPHC Study) Group: Members of the JPHC Study Group (principal investigator: S. Tsugane): M. Inoue, T. Hanaoka, S. Tsugane, S. Yamamoto, and T. Sobue, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo; J. Ogata, S. Baba, T. Mannami, and A. Okayama, National Cardiovascular Center, Suita; K. Miyakawa, F. Saito, A. Koizumi, Y. Sano, and I. Hashimoto, Iwate Prefectural Ninohe Public Health Center, Ninohe; Y. Miyajima, N. Suzuki, S. Nagasawa, and Y. Furusugi, Akita Prefectural Yokote Public Health Center, Yokote; H. Sanada, Y. Hatayama, F. Kobayashi, H. Uchino, Y. Shirai, T. Kondo, R. Sasaki, and Y. Watanabe, Nagano Prefectural Saku Public Health Center, Saku; Y. Kishimoto, E. Takara, T. Fukuyama, M. Kinjo, and M. Irei, Okinawa Prefectural Ishikawa (Chubu) Public Health Center, Ishikawa; K. Imoto, H. Yazawa, T. Seo, A. Seiko, and F. Ito, Katsushika Public Health Center, Tokyo; A. Murata, K. Minato, K. Motegi, and T. Fujieda, Ibaraki Prefectural Kasama (Mito) Public Health Center, Mito; K. Matsui, T. Abe, and M. Katagiri, Niigata Prefectural Kashiwazaki Public Health Center, Kashiwazaki; M. Doi, A. Terao, and Y. Ishikawa, Kochi Prefectural Tosayamada (Chuo-higashi) Public Health Center, Tosayamada; H. Sueta, H. Doi, M. Urata, N. Okamoto, and F. Ide, Nagasaki Prefectural Arikawa (Kamigoto) Public Health Center, Arikawa; H. Sakiyama, N. Onga, and H. Takaesu, Okinawa Prefectural Miyako Public Health Center, Hirara; F. Horii, I. Asano, H. Yamaguchi, K. Aoki, S. Maruyama, and M. Ichii, Osaka Prefectural Suita Public Health Center, Suita; S. Matsushima and S. Natsukawa, Saku General Hospital, Usuda; S. Watanabe and M. Akabane, Tokyo University of Agriculture, Tokyo; M. Konishi, and K. Okada, Ehime University, Matsuyama; H. Iso and Y. Honda, Tsukuba University, Tsukuba; H. Sugimura, Hamamatsu University, Hamamatsu; Y. Tsubono, Tohoku University, Sendai; M. Kabuto, National Institute for Environmental Studies, Tsukuba; S. Tominaga, Aichi Cancer Center Research Institute, Nagoya; M. Iida and W. Ajiki, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka; S. Sato, Osaka Medical Center for Health Science and Promotion, Osaka; N. Yasuda, Kochi University, Kochi; S. Kono, Kyushu University, Fukuoka; K. Suzuki, Research Institute for Brain and Blood Vessels Akita, Akita; Y. Takashima, Kyorin University, Mitaka; E. Maruyama, Kobe University, Kobe; the late M. Yamaguchi, Y. Matsumura and S. Sasaki, National Institute of Health and Nutrition, Tokyo; T. Kadowaki, Tokyo University, Tokyo.

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Iwasaki, M., Yamamoto, S., Otani, T. et al. Generalizability of Relative Risk Estimates from a Well-defined Population to a General Population. Eur J Epidemiol 21, 253–262 (2006). https://doi.org/10.1007/s10654-006-0004-z

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  • DOI: https://doi.org/10.1007/s10654-006-0004-z

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