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American Journal of Epidemiology Advance Access originally published online on June 24, 2007
American Journal of Epidemiology 2007 166(6):717-723; doi:10.1093/aje/kwm131
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Birth Order and Sibship Size: Evaluation of the Role of Selection Bias in a Case-Control Study of Non-Hodgkin's Lymphoma

FK Mensah1,2, EV Willett1, J Simpson1, AG Smith1 and E Roman1

1 Epidemiology and Genetics Unit, Department of Health Sciences, University of York, York, United Kingdom
2 Department of Social Policy and Social Work, University of York, York, United Kingdom

Correspondence to Dr. Eve Roman, Epidemiology and Genetics Unit, Department of Health Sciences, Seebohm Rowntree Building, University of York, York YO10 5DD, United Kingdom (e-mail: Eve.Roman{at}egu.york.ac.uk).

Received for publication May 23, 2006. Accepted for publication March 19, 2007.

Substantial heterogeneity has been observed among case-control studies investigating associations between non-Hodgkin's lymphoma and familial characteristics, such as birth order and sibship size. The potential role of selection bias in explaining such heterogeneity is considered within this study. Selection bias according to familial characteristics and socioeconomic status is investigated within a United Kingdom-based case-control study of non-Hodgkin's lymphoma diagnosed during 1998–2001. Reported distributions of birth order and maternal age are each compared with expected reference distributions derived using national birth statistics from the United Kingdom. A method is detailed in which yearly data are used to derive expected distributions, taking account of variability in birth statistics over time. Census data are used to reweight both the case and control study populations such that they are comparable with the general population with regard to socioeconomic status. The authors found little support for an association between non-Hodgkin's lymphoma and birth order or family size and little evidence for an influence of selection bias. However, the findings suggest that between-study heterogeneity could be explained by selection biases that influence the demographic characteristics of participants.

birth order; case-control studies; lymphoma, non-Hodgkin; selection bias; siblings

Abbreviations: ONS, Office for National Statistics


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