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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Assessment of Selection Bias in Clinic-Based Populations of Childhood Cancer Survivors</title><author><name sortKey="Ness, Kirsten K" sort="Ness, Kirsten K" uniqKey="Ness K" first="Kirsten K." last="Ness">Kirsten K. Ness</name><affiliation><nlm:aff id="A1">Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</nlm:aff></affiliation></author><author><name sortKey="Leisenring, Wendy" sort="Leisenring, Wendy" uniqKey="Leisenring W" first="Wendy" last="Leisenring">Wendy Leisenring</name><affiliation><nlm:aff id="A2">Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Goodman, Pam" sort="Goodman, Pam" uniqKey="Goodman P" first="Pam" last="Goodman">Pam Goodman</name><affiliation><nlm:aff id="A2">Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Kawashima, Toana" sort="Kawashima, Toana" uniqKey="Kawashima T" first="Toana" last="Kawashima">Toana Kawashima</name><affiliation><nlm:aff id="A2">Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Mertens, Ann C" sort="Mertens, Ann C" uniqKey="Mertens A" first="Ann C." last="Mertens">Ann C. Mertens</name><affiliation><nlm:aff id="A3">Department of Pediatrics, Emory University, Atlanta, GA</nlm:aff></affiliation></author><author><name sortKey="Oeffinger, Kevin C" sort="Oeffinger, Kevin C" uniqKey="Oeffinger K" first="Kevin C." last="Oeffinger">Kevin C. Oeffinger</name><affiliation><nlm:aff id="A4">Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY</nlm:aff></affiliation></author><author><name sortKey="Armstrong, Gregory T" sort="Armstrong, Gregory T" uniqKey="Armstrong G" first="Gregory T." last="Armstrong">Gregory T. Armstrong</name><affiliation><nlm:aff id="A1">Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</nlm:aff></affiliation></author><author><name sortKey="Robison, Leslie L" sort="Robison, Leslie L" uniqKey="Robison L" first="Leslie L." last="Robison">Leslie L. Robison</name><affiliation><nlm:aff id="A1">Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18989878</idno><idno type="pmc">2628420</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628420</idno><idno type="RBID">PMC:2628420</idno><idno type="doi">10.1002/pbc.21829</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">002811</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002811</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Assessment of Selection Bias in Clinic-Based Populations of Childhood Cancer Survivors</title><author><name sortKey="Ness, Kirsten K" sort="Ness, Kirsten K" uniqKey="Ness K" first="Kirsten K." last="Ness">Kirsten K. Ness</name><affiliation><nlm:aff id="A1">Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</nlm:aff></affiliation></author><author><name sortKey="Leisenring, Wendy" sort="Leisenring, Wendy" uniqKey="Leisenring W" first="Wendy" last="Leisenring">Wendy Leisenring</name><affiliation><nlm:aff id="A2">Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Goodman, Pam" sort="Goodman, Pam" uniqKey="Goodman P" first="Pam" last="Goodman">Pam Goodman</name><affiliation><nlm:aff id="A2">Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Kawashima, Toana" sort="Kawashima, Toana" uniqKey="Kawashima T" first="Toana" last="Kawashima">Toana Kawashima</name><affiliation><nlm:aff id="A2">Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</nlm:aff></affiliation></author><author><name sortKey="Mertens, Ann C" sort="Mertens, Ann C" uniqKey="Mertens A" first="Ann C." last="Mertens">Ann C. Mertens</name><affiliation><nlm:aff id="A3">Department of Pediatrics, Emory University, Atlanta, GA</nlm:aff></affiliation></author><author><name sortKey="Oeffinger, Kevin C" sort="Oeffinger, Kevin C" uniqKey="Oeffinger K" first="Kevin C." last="Oeffinger">Kevin C. Oeffinger</name><affiliation><nlm:aff id="A4">Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY</nlm:aff></affiliation></author><author><name sortKey="Armstrong, Gregory T" sort="Armstrong, Gregory T" uniqKey="Armstrong G" first="Gregory T." last="Armstrong">Gregory T. Armstrong</name><affiliation><nlm:aff id="A1">Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</nlm:aff></affiliation></author><author><name sortKey="Robison, Leslie L" sort="Robison, Leslie L" uniqKey="Robison L" first="Leslie L." last="Robison">Leslie L. Robison</name><affiliation><nlm:aff id="A1">Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</nlm:aff></affiliation></author></analytic><series><title level="j">Pediatric blood & cancer</title><idno type="ISSN">1545-5009</idno><idno type="eISSN">1545-5017</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">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.</p></sec><sec id="S2"><title>Procedure</title><p id="P2">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.</p></sec><sec id="S3"><title>Results</title><p id="P3">When compared to survivors who had no medical care in the previous two 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 1.1-1.3) 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%).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">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.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101186624</journal-id><journal-id journal-id-type="pubmed-jr-id">30479</journal-id><journal-id journal-id-type="nlm-ta">Pediatr Blood Cancer</journal-id><journal-title>Pediatric blood & cancer</journal-title><issn pub-type="ppub">1545-5009</issn><issn pub-type="epub">1545-5017</issn></journal-meta><article-meta><article-id pub-id-type="pmid">18989878</article-id><article-id pub-id-type="pmc">2628420</article-id><article-id pub-id-type="doi">10.1002/pbc.21829</article-id><article-id pub-id-type="manuscript">NIHMS77439</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Assessment of Selection Bias in Clinic-Based Populations of Childhood Cancer Survivors</article-title><subtitle>A Report from the Childhood Cancer Survivor Study</subtitle></title-group><contrib-group><contrib contrib-type="author"><name><surname>Ness</surname><given-names>Kirsten K.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Leisenring</surname><given-names>Wendy</given-names></name><degrees>ScD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Goodman</surname><given-names>Pam</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Kawashima</surname><given-names>Toana</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mertens</surname><given-names>Ann C.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Oeffinger</surname><given-names>Kevin C.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Armstrong</surname><given-names>Gregory T.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Robison</surname><given-names>Leslie L.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN</aff><aff id="A2"><label>2</label>Department of Biostatistics, Fred Hutchinson Cancer Research Center, Seattle, WA</aff><aff id="A3"><label>3</label>Department of Pediatrics, Emory University, Atlanta, GA</aff><aff id="A4"><label>4</label>Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY</aff><author-notes><corresp id="CR1"><bold>Corresponding Author:</bold> Kirsten K. Ness, PhD Assistant Member St. Jude Children’s Research Hospital Mail Stop 735 262 Danny Thomas Place Memphis, TN 38105 Phone: 901-495-5157 Fax: 901-495-5845 E-mail: <email>kiri.ness@stjude.org</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>14</day><month>11</month><year>2008</year></pub-date><pub-date pub-type="ppub"><month>3</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>3</month><year>2010</year></pub-date><volume>52</volume><issue>3</issue><fpage>379</fpage><lpage>386</lpage><abstract><sec id="S1"><title>Background</title><p id="P1">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.</p></sec><sec id="S2"><title>Procedure</title><p id="P2">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.</p></sec><sec id="S3"><title>Results</title><p id="P3">When compared to survivors who had no medical care in the previous two 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 1.1-1.3) 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%).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">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.</p></sec></abstract><contract-num rid="CA1">U24 CA055727-14
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