A decision analysis framework is used to explore the value of screening tests for carcinogenicity. Whether a test lowers the social cost of screening depends on the test's sensitivity, specificity, and cost and the social cost of misclassification (exonerating carcinogenic chemicals or condemning noncarcinogenic chemicals). The model shows that the best screening test need not be either the most accurate or the least expensive.
References
1.
1. National Research Council. (1984). Toxicity Testing: Strategies to Determine Needs and Priorities.Washington, DC: National Academy Press.
2.
2. Lave, L.B., and Upton, A.C. (eds.). (1987). Toxic Substances, Health, and the Environment.Baltimore: Johns Hopkins University Press.
3.
3. Us General Accounting Office. (June 15, 1984). Assessment of New Chemical Regulation Under the Toxic Substances Control Act, GAO/RCED 84–84. Washington: US General Accounting Office.
4.
4. Lave, L.B. (1987). Health and Safety Risk Analyses. Science236, 291–295.
5.
5. Lave, L.B. (1985). Improving the management of environmental health. Environ. Health Perspect.62, 359–363.
6.
6. Ruckelshaus, W. (1985). Risk, Science, and Democracy. Issues Sci. Technol.1, 19–38.
7.
7. Covello, V.T., Menkes, J., and Mumpower, J. (1986). Risk Analysis and management.New York: Plenum.
8.
8. Omenn, G.S. (1986). A framework for risk assessment for environmental chemicals. Washington Public Health6, 2–6.
9.
9. Page, T. (1978). A generic view of toxic chemicals and similar risks. Ecology Law Q.7, 207–244.
10.
10. Weinstein, M.C. (1979). Decision making for toxic substances control: Cost-effective information development for the control of environmental carcinogens. Public Policy27, 333–343.
11.
11. Bogle, G., and Page, T. (1982). Priority setting for testing chemicals. In: Safety Evaluation and Regulation of Chemicals.F. Homburger (ed.). Boston: S. Karger.
12.
12. Lave, L.B., Omenn, G.S., Heffernan, K.D., and Dranoff, G. (1983). A model for selecting short-term tests of carcinogenicity. J. Am. Coll. Toxicol.2, 125–130.
13.
13. Weinstein, I.B. (1983). The monitoring of DNA adduets as an approach to carcinogen detection. Annu. Rev. Public Health4, 409–413.
14.
14. Hoel, D.G., Merrill, R.A., and Perera, F.P. (1985). Risk Quantification and Regulatory Policy.Cold Spring Harbor, NY: Cold Spring Harbor Laboratory, Banbury Report 19.
15.
15. Hattis, D.B. (1986). The promise of molecular epidemiology for quantitative risk assessment. Risk Analysis6, 181–194.
16.
16. Perera, F. (1986). New approaches in risk assessment in carcinogens. Risk Analysis6, 195–202.
17.
17. Us Office Of Science And Technology Policy. (1985). Federal Register50, 10371–10442.
18.
18. Omenn, G.S. (1984). Characterizing risks: Utilizing knowledge about mechanisms. In: Molecular and Cellular Approaches to Understanding Mechanisms of Toxicology.A.H. Tashjian, Jr. (ed.). Boston: Harvard School of Public Health, pp. 224–245.
19.
19. Ashby, J., De Serres, F.J., Draper, M.H., Ishidate, M., Jr., Margolin, B.H., Matter, B.E., and Shelby, M. (eds.). (1985). Evaluation of Short-Term Tests for Carcinogens: Report of the International Programme on Chemical Safety Collaborative Study on in Vitro Assays. Progress in Mutation Research.Amsterdam: Elsevier Science Publishers, Vol. 5.
20.
20. World Health Organization. (1985). Summary Report on the Evaluation of Short-Term Tests for Carcinogens (Collaborative Study on in Vitro Tests). Environmental Health Criteria 47, Geneva: WHO.
21.
21. Ames, B.N., Mccann, J., and Yamasaki, E. (1975). Methods for detecting carcinogens and mutagens with the Salmonella/mammalian-microsome mutagenicity test. Mutat. Res.31, 347–364.
22.
22. Bridges, B.S. (1976). In: Screening Tests in Chemical Carcinogenesis.R. Montesano, H. Bartsch, and L. Romatis (eds.). Lyon, France: International Agency for Research on Cancer.
23.
23. Marcus, W.L. (1978). In: Carcinogenesis: A Comprehensive Survey, Vol. 3: Polynuclear Aromatic Hydrocarbons.P.W. Jones and R.I. Fruendenthal (eds.). New York: Raven.
24.
24. National Toxicology Program. (1980). Technical Bulletin 1, 2.
25.
25. Purchase, I.F. (1982). International commission for protection against environmental mutagens and carcinogens. Mutat. Res.99, 53–71.
26.
26. Weisburger, J.H., and Williams, G.M. (1981). Carcinogen testing: Current problems and new approaches. Science214, 401–407.
27.
27. Williams, G.M. (1980). Batteries of short-term tests for carcinogen screening. In: The Predictive Values of Short-Term Screening Tests in Carcinogenicity Evaluation.G.M. Williamset al. (eds.). Amsterdam: Elsevier.
28.
28. Williams, G.D., Laspia, M.F., and Dunkel, V.C. (1982). Reliability of the hepatocyte primary culture/DNA repair test and testing of coded carcinogens and non-carcinogens. Mutat. Res.97, 359–370.
29.
29. Lave, L.B., and Omenn, G.S. (1986). Cost-effectiveness of short-term tests for carcinogenicity. Nature324, 29–35.
30.
30. Breslow, N., and Kaldor, J. (1985). Statistical approaches to the estimation and testing of mutagenic potency with data from in vitro tests. IARC Workshop paper.
31.
31. Chankong, V., Haïmes, Y.Y., Rosenkranz, H., and Pet-Edwards, J. (1985). The carcinogenicity prediction and battery selection (CPBS) method: A bayesian approach. Mutat. Res.153, 135–166.
32.
32. Pet-Edwards, J., Rosenkranz, H.S., Chankong, V., and Haimes, Y.Y. (1985). Cluster analysis and predicting the carcinogenicity of chemicals using short-term assays. Mutat. Res.153, 167–185.
33.
33. Pet-Edwards, J., Chankong, V., Rosenkranz, H.S., and Haimes, Y.Y. (1985). Application of the carcinogenicity prediction and battery selection (CPBS) method to the gene-tox data base. Mutat. Res.153, 187–200.
34.
34. Goldstein, M., and Dillon, W.R. (1978). Discrete Discriminant Analysis.New York: Wiley.
35.
35. DeSerres, F.J., and Ashby, J. (eds.). (1981). Evaluation of Short-Term Tests for Carcinogens: Report of the International Collaborative Program.New York: Elsevier.
