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IJE Advance Access originally published online on March 23, 2006
International Journal of Epidemiology 2006 35(3):756-764; doi:10.1093/ije/dyl044
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.

Article

A design for cancer case–control studies using only incident cases: experience with the GEM study of melanoma

Colin B Begg1,*, Amanda J Hummer1, Urvi Mujumdar1, Bruce K Armstrong2, Anne Kricker2, Loraine D Marrett3, Robert C Millikan4, Stephen B Gruber5, Hoda Anton Culver6, Roberto Zanetti7, Richard P Gallagher8, Terrence Dwyer9, Timothy R Rebbeck10, Klaus Busam1, Lynn From3, Marianne Berwick11 for the GEM Study Group

1 Memorial Sloan-Kettering Cancer Center, New York, NY
2 The University of Sydney and Cancer Council New South Wales, Sydney, Australia
3 Cancer Care Ontario, Toronto, Canada
4 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
5 University of Michigan, Ann Arbor, MI, USA
6 University of California at Irvine, Irvine, CA, USA
7 Centro per la Prevenzione Oncologia Torino, Torino, Piemonte, Italy
8 British Columbia Cancer Agency, Vancouver, Canada
9 Murdoch Childrens Research Institute, Melbourne, Victoria 3052, Australia
10 University of Pennsylvania, Philadelphia, PA, USA
11 University of New Mexico, Albuquerque, NM

* Corresponding author. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E. 63rd Street, 3rd Floor, New York, NY 10021, USA. E-mail: beggc{at}mskcc.org

Background The population-based case–control study is not suited to the evaluation of rare genetic (or environmental) factors. The use of a novel case–control design in which cases have second primaries and controls are cancer survivors has been proposed for this purpose.

Methods We report results from an international study of melanoma that involved population-based ascertainment of incident cases of second or subsequent primary melanoma as the ‘case’ group and incident cases of first primary melanoma as the ‘control’ group. We evaluate the validity of the study design by comparing the results obtained for phenotypic factors that have been shown consistently to be associated with melanoma in previous conventional studies with the results from a conventional case–control study conducted in Connecticut and from literature reviews.

Results All but one of the known risk factors for melanoma were shown to be significantly associated with melanoma in our study, though the individual odds ratios appear to be somewhat attenuated relative to the magnitudes typically observed in the literature.

Conclusions Patients with a second or subsequent primary cancer of a single type represent a potentially valuable and under-utilized resource for the study of cancer aetiology.

Keywords Case-control study, case-only study, melanoma

Accepted 22 February 2006


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