Epidemiology Questions and Discussion


1.Suppose that you are following a group of children for the development of asthma over a one- year period. You identify 100 childrenon January 1st, screen them for asthma, and set up a monitoring program to check on their status on a monthly basis. Five children areconsidered prevalent cases because they were diagnosed with asthma before January 1st. Ten children develop asthma on March 1stand another ten children develop asthma on July 1st. Another 10 children who remain healthy were followed for six months and thenwere lost to follow-up. All of the remaining children did not develop asthma and were not lost to follow-up. Follow-up ended onDecember 31st.

What was the prevalence of asthma on June 1st?

What was the prevalence of asthma on September 1st?

How many person-months of observation were accrued by this population?

What was the incidence rate of asthma in this population for the one-year period?



1.How does each of the following conditions influence the prevalence of a disease in a population? For each scenario, assume that noother changes occur. Your choices are: increases prevalence, decreases prevalence, or has no effect on prevalence.

A treatment is developed that prolongs the life of people suffering from the disease

A new measure is developed that prevents new cases of disease from occurring

There is immigration of a large number of healthy people into the population.

The case-fatality rate for the disease increases



1.An epidemiological investigation was begun on July 1, 2000 among a population of 1,000 individuals. Three individuals were foundto have leukemia on July 1st. During the ten-year follow-up period, five new cases of leukemia were diagnosed. Among the eightleukemia cases, four deaths occurred during the ten-year follow-up period. Two additional individuals, neither of whom had leukemia,were lost to follow-up at some point during follow-up. None of the remaining 990 study participants became ill, died, or were lost tofollow-up during the follow-up period.The diagram below indicates the experience of the 10 study participants, using the following symbols:
:case recognition (diagnosis of leukemia)
:onset of leukemia was prior to start of study period
:observation period during follow-up
:status at termination of observation (i.e., alive, dead, lost)
case 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 1 — –*– —– —– —– —– —– —– —– —– –X alive 2 — —— —– –*– —– —– —– —– —– —– –X alive 3 *<– —— —— —– —– —– —– —– –X dead 4 — —— —– —– –X lost 5 — —— —– —– —– —– –*– –X dead 6 — —— —– —– —– —– —– —– —– –*– –X alive 7 — –*– —– —– –X dead 8 *<– —— —— —– —– —– —– —– —– —– —– –X alive 9 — —— —– —– —– —– —– –X lost 10 *<– —— —— –X dead
Descriptive Epidemiology Case Study To complete the assignment, access the following resource: Howlader N, Noone AM, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z,Mariotto A, Lewis DR, Chen HS, Feuer EJ, Cronin KA (eds). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD, based on November 2013 SEER data submission, posted to the SEER web site, April 2014. Using the “Browse the Tables and Figures” function, find the information in the SEER Cancer Statistics Review to answer the following questions: Overview

1)What is the estimated number of new cancer cases for 2014, for all cancer sites combined?
2)What is the estimated number of cancer deaths for 2014 from brain and other nervous system cancer?_____________________________
Annual Incidence Rates
3)Find the 2011 age-adjusted incidence rates for liver and intrahepatic bile duct cancer. What was the rate forboth sexes? ___________
a.What was the 2011 age-adjusted incidence rate for males? _____________________
b.What was the 2011 age-adjusted incidence rate for females? ____________________
c.Interpret each of these two sex-specific rates in words. Then, discuss how they compare to each other.________________________________________________________________________________________________________________________________________________
4)Find the 1975-2011 age-adjusted incidence rates for urinary bladder cancer. What was the rate for males of allraces? _______________________
a.What was the 1975-2011 age-adjusted incidence rate for white males?______________
b.What was the 1975-2011 age adjusted incidence rate for black males? ______________
c.Interpret each of these two race-specific rates in words. Then, discuss how they compare to each other?________________________________________________________________________________________________________________________________________________
5)What does it mean that these incidence rates are ‘age-adjusted?’____________________________________________________________________________________________________________________________________________________________
6)Why do we use age-adjustment when publishing cancer incidence and mortality rates?____________________________________________________________________________________________________________________________________________________________
5-Year Relative and Period Survival
7)Find the 5-Year relative survival (%) for 2004-2010 by age at diagnosis for colon and rectum cancer.
a.What was the 5-year relative survival for:
i.Persons <45 years old at diagnosis? _______________
ii.Persons 45-54 years old at diagnosis?_______________
iii.Persons 55-64 years old at diagnosis?_______________
iv.Persons 65-74 years old at diagnosis?_______________
v.Persons 75 and older at diagnosis?__________________
b.Describe in words these differences in 5-year relative survival by age:________________________________________________________________________________________________________________________________________________
c.Now look at these same statistics for Whites (both sexes) and Blacks (both sexes). Describe anysimilarities or differences you see in the 5-year relative survival by age.________________________________________________________________________________________________________________________________________________
d.Based on these data, can conclusions be drawn as to why these statistics are similar or different? Why orwhy not?________________________________________________________________________________________________________________________________________________
Age-Adjusted Cancer Death Rates
8)Find the age-adjusted cancer death rates by state (both sexes), for melanoma of the skin.
a.Which state has the highest age-adjusted death rate from melanoma? ___________
b.Which state has the lowest age-adjusted death rate from melanoma? ____________
9)Scroll down to the map of the United States showing the state-specific cancer death rates from melanoma.
a.In which regions of the United States are the states with the highest cancer death rates generallylocated?________________________________________________________
b.In which regions of the United States are the states with the lowest cancer death rates generallylocated? ________________________________________________________
10)Based on this map, what national public health strategies would you recommend in order to reduce the cancerdeath rate from melanoma? How does the information on the map affect how you would target thesestrategies?__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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