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Modélisation statistique de l'intensité des expositions prolongées en étiologie du cancer : application au tabac, à l'amiante, au cancer du poumon, et au mésothéliome pleural

Abstract : The association between smoking and lung cancer or between occupational exposure to asbestos and pleural mesothelioma have been extensively investigated. Nevertheless, as for many protracted exposures-cancer relationships, the role of exposure intensity over lifetime has been rarely addressed. Accounting for individual variation of intensity over lifetime and investigating time-dependent effect in the statistical analysis of case-control data indeed raise several methodological issues. The thesis objectives were 1) to study the time-dependent effect of exposure intensity over lifetime on the risk of cancer and 2) to identify lifetime profiles of exposure intensities and to compare their associated risks of cancer. To address these objectives, we used an existing flexible weighted cumulative index of exposure and we developed a new joint latent class mixed model, to analyze the data from two French case-control studies on lung cancer and pleural mesothelioma. The results show the important contribution of recent smoking intensity for lung cancer and distant intensity of exposure to asbestos for both cancers. They confirm the importance of the timing of exposure in the association with the risk of cancer and illustrate the relevance of the proposed statistical approaches.
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https://tel.archives-ouvertes.fr/tel-02046179
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Submitted on : Friday, February 22, 2019 - 3:33:19 PM
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Emilie Leveque. Modélisation statistique de l'intensité des expositions prolongées en étiologie du cancer : application au tabac, à l'amiante, au cancer du poumon, et au mésothéliome pleural. Médecine humaine et pathologie. Université de Bordeaux, 2018. Français. ⟨NNT : 2018BORD0315⟩. ⟨tel-02046179⟩

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