title: Specificity of association in analysis of mortality and inference on causality.
abstract: Specificity of association between putative risk factor and disease under study is important to inference on causality. Nevertheless many studies investigate mortality of a single disease without comparison with a control. Age-standardized proportional mortality ratios make single disease studies into case-control studies and thus demonstrate whether or not associations are disease specific. Comparison of disease-specific with all-cause mortality experiences of whole populations classified by exposure, clearly distinguishes between exposures associated with more death and with earlier/younger death, thereby overcoming an important limitation of the familiar standardized mortality ratio (SMR). Smoking is associated with more death from lung cancer (lifetime cause-specific proportions, never 1%, light 6%, moderate 8% and heavy 12%) and with earlier/younger death from ischaemic heart disease (never 35%, light 34%, moderate 32% and heavy 29%).
authors.affiliation: Department of Epidemiology, University of Wales College of Medicine, Heath Park, Cardiff, UK.
authors.forename: R R
authors.initials: RR
authors.lastname: West
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015984:Causality; D004812:Epidemiologic Methods; D006331:Heart Diseases / Q000401:mortality; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality; D008875:Middle Aged; D009026:Mortality; D012107:Research Design; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012907:Smoking / Q000401:mortality