Journal of the Formosan Medical Association
Volume 109, Issue 5 , Pages 369-377, May 2010

Case-Spouse Control Design in Practice: An Experience in Estimating Smoking and Chronic Obstructive Pulmonary Disease Deaths in Chinese Adults

  • Jingmei Jiang

      Affiliations

    • Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
    • ,
  • Boqi Liu

      Affiliations

    • The Cancer Institute, Chinese Academy of Medical Sciences, Beijing, China
    • Corresponding Author InformationCorrespondence to: Dr Boqi Liu, National Cancer Institute, Chinese Academy of Medical Sciences, 17 Pan Jia Yuan Nan Li, Beijing 100021, China
    • ,
  • Freddy Sitas

      Affiliations

    • Cancer Epidemiology Research Unit, The Cancer Council NSW, Australia
    • ,
  • Xianjia Zeng

      Affiliations

    • Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
    • ,
  • Junshi Chen

      Affiliations

    • The Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, Beijing, China
    • ,
  • Wei Han

      Affiliations

    • Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, Beijing, China
    • ,
  • Xiaonong Zou

      Affiliations

    • The Cancer Institute, Chinese Academy of Medical Sciences, Beijing, China
    • ,
  • Yanping Wu

      Affiliations

    • The Cancer Institute, Chinese Academy of Medical Sciences, Beijing, China
    • ,
  • Ping Zhao

      Affiliations

    • The Cancer Institute, Chinese Academy of Medical Sciences, Beijing, China
    • ,
  • Junyao Li

      Affiliations

    • The Cancer Institute, Chinese Academy of Medical Sciences, Beijing, China

Received 4 September 2008; received in revised form 26 June 2009; accepted 31 August 2009.

Article Outline

Background/Purpose

We assessed the effect of smoking on death from chronic obstructive pulmonary disease (COPD) in China by employing a large population-based, case-spouse control study design using data from a nationwide survey of mortality.

Methods

During 1989-1991, a nationwide retrospective survey of mortality was conducted in China. For approximately 1,000,000 adults dying from all causes during 1986-1988, their surviving spouses or other informants provided detailed information about their own as well as the deceased person's smoking history. For this study, 183,393 individuals who died of COPD at age ≥ 40 years were taken as cases, while 272,984 sex-matched surviving spouses of subjects who died from any cause were taken as controls.

Results

COPD death rates for smokers were more than twice as high as those of non-smokers, with a dose-response risk pattern, despite the fact that COPD death rates varied widely by region and age. Tobacco accounted for 41.4% of COPD deaths in men, but only 13.5% of those in women, who had a lower rate of smoking.

Conclusion

A case-spouse control study, as an alternative design, is valid and feasible in utilizing information from population-based, retrospective mortality survey data for an analytical epidemiological study of disease etiology.

Key Words:  case-control studies , China , chronic obstructive pulmonary diseases , mortality , smoking

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PII: S0929-6646(10)60065-4

doi:10.1016/S0929-6646(10)60065-4

Journal of the Formosan Medical Association
Volume 109, Issue 5 , Pages 369-377, May 2010

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