O-58 Lessons learned from evaluating epidemiological studies for cancer hazard identification the updated report on carcinogens (RoC) handbook. (14th March 2023)

• Record Type: Journal Article
• Authors: Lunn, Ruth M; Schwingl, Pamela; Mehta, Suril S; Marder, Elizabeth; Arroyave, Whitney; Elizabeth Hodgson, M; Guha, Neela
• Is Part Of: Occupational and environmental medicine. Volume 80(2023)Supplement 1
• Page Start: A82
• Page End: A82
• Publication Date: 2023-03-14
• Subjects: Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; 616.980305
• DOI: 10.1136/OEM-2023-EPICOH.201
• Languages: English
• ISSNs: 1351-0711

Abstract

Abstract : Introduction: Although systematic reviews aim to increase transparency and rigor in health evaluations for public health decision-making, some methodologies have been criticized for being algorithmic, maladapted to the complexity and diversity of environmental and occupational epidemiology studies, or misused by reviewers without adequate expertise. Need for continual methods refinement has prompted both the development and updated RoC handbook. Methods: The RoC handbook provides guidance to conduct systematic reviews and integrate evidence to identify cancer hazards. Evaluating the informativeness of epidemiological studies focuses on the direction, magnitude, and impact of biases and study sensitivity. Updates to the RoC handbook, which will be peer reviewed and published as a living document, are based on its application to 7 RoC and 3 OEHHA cancer hazard evaluations and methodological advancements in epidemiology and systematic review. Results: New features of the updated handbook are interactive evidence maps to inform the review approach for each exposure-outcome pair and enhanced guidance to evaluate exposure misclassification and integrate evidence across studies. Assessing exposure misclassification considers (1) how well the exposure proxy approximates the exposure of interest, (2) how accurately and precisely the exposure (or proxy) is measured, and (3) differential recall bias or observational bias. Because cancer epidemiology studies employ a wide range of methods to assess exposure, the handbook provides direction to evaluate specific methods (e.g., environmental measurement, job exposure matrices). Evidence integration includes triangulation and systematic approaches to explore the impact of biases and confounding, effect modifiers, exposure metrics, and other sources of heterogeneity. Conclusions: The revised RoC handbook strives to balance the advantages of systematic and narrative reviews and focus on key issues in environmental and occupational epidemiology. In addition to providing transparency for our evaluations, we hope it can serve as a resource to scientists who appraise the epidemiologic literature.