Acceleration of time to onset of a disease due to professional exposure.

International audienceAbstractEstimation of the number of expected years of life free disease lost due to an occupational exposure is frequently required asthe amount of compensation due to the worker relies upon this estimation. The motivating example was a French case-cohort study on the occurrence of lung cancer for workers exposed to asbestos. For a case-cohort study the most usual models are the logistic ones. But this is adequate only if the aim is to evaluate the risks of developing the disease, which is not our objective. Several models, though, can be used in order to solve our problem. One of the simplest is the Cox model involving the professional exposure as a covariate at the same level as other risk factors that could also induce lungcancer, like for example family history of cancer and tobacco consumption. But we can also think of adapting to case-control study the threshold regression model, also named first hitting time model (fht), which was initially developed for cohort studies. This model allows us to treat the professional exposure as an accelerator of the time to onset of the disease, while the other covariates are divided into two classes, acting differently on the time to onset: the built-in ones (like genetic factors for example) and the lifelong ones, (like tobacco consumption for example