An epidemiologist found five cases of “big toe cancer” in the Yukon Territory.

Because there
were only a few cases, the epidemiologist decided to conduct a matched case-control study to
determine whether shoe size larger than 9 is a risk factor for big toe cancer. Cases were
individually matched to one control for daily activity, history of athlete’s foot, and history of
ingrown toenails. The following data were gathered:

Shoe size > 9

Pair Case Control
1 Yes No
2 No No
3 No Yes
4 Yes Yes
5 No Yes
1. Compute the proper measure of association.
2. Interpret your results.
3. If you were to investigate a rare cancer in Lynchburg, where might you look for data?

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4. What would be necessary legally and ethically to be able to utilize this data set(s)?

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1.The way to find the measure of association is finding the correlation coefficient, and to do so I

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will have to convert qualitative data into quantitative data were yes=1 and no =0
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2.X =1,0,0,1,0 or 2 X*Y=0,0,0,1,0 or 1 X^2= 1,0,0,101 or 2 Y^2 0,0,0,1,1or 2
Y=0,0,0,1,1 or 2 using the formula the correlation coefficient or r=.1667
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3.If I were to investigate a rare cancer in Lynchburg I would look for information from the
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Disease registries, with ties to population based registries like the surveillance, Epidemiology,
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and End Result (SEER). According to Friis and Sellers with this form of information because it
is statistics based on existing registered cases of cancer that is continuously available on different
levels from the state, national, local jurisdictions. These records are presumed to be complete for
the diagnosed disease and useful for the study incidence of the disease such as cancer; used to
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select cases in a case-control study.

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4. As far as ethics are concerned in gathering information I think the subjects have the right to
know that there medical information is being use. I would send out letters to let them know what
information is needed and how it is being used. As for the legal aspect, there are many laws in
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place to protect patients and the data collected from them. According to chapter 15 of the Cancer
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registration: legal aspects and confidentially by C.S. Muir and E. Demaret the legal aspect
requires several steps Confidential data should be provided by the cancer registry only on written
request. The request should include (a) the exact purpose for which dates are needed; (b) the
information required; (c) the name of the persons who will be responsible for keeping the
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confidential information; and (d) the time period for which the data are needed. When
confidential data are requested it has to be confirmed that (a) those receiving the data are bound
by the principles of confidentiality observed by the personnel of the cancer registry; the recipient
conforms to the restrictions on the use of the data, specifically that they are not used for purposes
other than those agreed upon at the time of provision and that the data are not communicated to
fourth parties; (c) contact with patients, or members of their family, whose names have been

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 provided in confidence by the cancer registry, is established only after obtaining the
authorization of the physician in charge of treatment; and data which are no longer needed for
the designated purpose will be returned or destroyed.

1. Friis, R., & Sellers, T. (2014). Epidemiology for Public Health Practice (5th Ed.). Burlington, Mass.:
Jones and Bartlett Learning.

2. Muir, C., & Demaret, E. (n.d.). Chapter 15. Cancer registration: Legal aspects and

confidentiality. Retrieved September 11, 2015.

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