Assessment of selection bias in clinic-based populations of childhood cancer survivors: A report from the childhood cancer survivor study

Kirsten K. Ness, Wendy Leisenring, Pam Goodman, Toana Kawashima, Ann C. Mertens, Kevin C. Oeffinger, Gregory Armstrong, Leslie L. Robison

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background. It is not known to what extent prevalence estimates of late effects among childhood cancer survivors derived from clinic based samples represent the actual estimates that would be derived if the entire population of childhood cancer survivors was recruited and evaluated for a particular outcome. Procedure. In a large retrospective cohort study of childhood cancer survivors, the Childhood Cancer Survivor Study(CCSS), the prevalence of chronic health conditions among participants who reported being seen in a cancer center or long-term follow-up clinic was compared to the prevalence of chronic conditions in the entire cohort. Results. When compared to survivors who had no medical care in the previous 2 years, survivors accessing medical follow-up were significantly more likely to have chronic health conditions. Relative risks of reporting a chronic health condition were 1.4(95% CI: 1.3-1.5) if seen in a cancer center or long-term follow-up clinic and 1.2(95% CI: 1.1-.3) if seen in a general medical care setting. Estimates derived from only those childhood cancer survivors who were seen in a cancer center or long-term follow-up clinic overestimate the prevalence of any chronic disease by 9.3%(95% CI: 7.0-11.6). Conclusions. Applying chronic condition prevalence estimates from a clinical population to the general population of childhood cancer survivors must be undertaken with caution. Survivorship research must maintain a high level of scientific rigor to ensure that results reported in the literature are interpreted within the appropriate context.

Original languageEnglish (US)
Pages (from-to)379-386
Number of pages8
JournalPediatric Blood and Cancer
Volume52
Issue number3
DOIs
StatePublished - Mar 1 2009
Externally publishedYes

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Selection Bias
Survivors
Population
Neoplasms
Health
Chronic Disease
Cohort Studies
Survival Rate
Retrospective Studies
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Ness, K. K., Leisenring, W., Goodman, P., Kawashima, T., Mertens, A. C., Oeffinger, K. C., ... Robison, L. L. (2009). Assessment of selection bias in clinic-based populations of childhood cancer survivors: A report from the childhood cancer survivor study. Pediatric Blood and Cancer, 52(3), 379-386. https://doi.org/10.1002/pbc.21829

Assessment of selection bias in clinic-based populations of childhood cancer survivors : A report from the childhood cancer survivor study. / Ness, Kirsten K.; Leisenring, Wendy; Goodman, Pam; Kawashima, Toana; Mertens, Ann C.; Oeffinger, Kevin C.; Armstrong, Gregory; Robison, Leslie L.

In: Pediatric Blood and Cancer, Vol. 52, No. 3, 01.03.2009, p. 379-386.

Research output: Contribution to journalArticle

Ness, Kirsten K. ; Leisenring, Wendy ; Goodman, Pam ; Kawashima, Toana ; Mertens, Ann C. ; Oeffinger, Kevin C. ; Armstrong, Gregory ; Robison, Leslie L. / Assessment of selection bias in clinic-based populations of childhood cancer survivors : A report from the childhood cancer survivor study. In: Pediatric Blood and Cancer. 2009 ; Vol. 52, No. 3. pp. 379-386.
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