Case-control studies: matched controls or all available controls?

In order to realize the variation in the estimate of the odds ratio from case-control studies, results from individually matched sampling were compared with those from the analysis based on a large number of controls. The subjects were selected from those who visited Aichi Cancer Center Hospital from 1988 to 1990. Cases consisted of 251 male lung cancer patients aged 40-79 years. Age and year of visit matched controls were sampled independently 100 times and 5000 times from non-cancer male outpatients (cases to controls ratio: 1:1, 1:2, 1:3, and 1:4). As unmatched controls, all male non-cancer outpatients aged 40-79 years (4100 patients) were used. The smoking habit was adopted as an exposure variable. As logically expected, analysis based on 4100 male controls gave a steadier estimate than the matched analyses examined here, indicating that a matched sampling is not recommended when a large number of controls are available.