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American Journal of Epidemiology Advance Access originally published online on November 6, 2007
American Journal of Epidemiology 2008 167(3):350-361; doi:10.1093/aje/kwm292
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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.

PRACTICE OF EPIDEMIOLOGY

Census and Geographic Differences between Respondents and Nonrespondents in a Case-Control Study of Non-Hodgkin Lymphoma

Min Shen1, Wendy Cozen2, Lan Huang3, Joanne Colt1, Anneclaire J. De Roos4,5, Richard K. Severson6,7, James R. Cerhan8, Leslie Bernstein2, Lindsay M. Morton1, Linda Pickle3 and Mary H. Ward1

1 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
2 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
3 Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
4 Fred Hutchinson Cancer Research Center, Seattle, WA
5 Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA
6 Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI
7 Karmanos Cancer Institute, Detroit, MI
8 Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN

Correspondence to Dr. Mary H. Ward, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd., Executive Plaza South 8006, MSC 7240, Rockville, MD 20892-7240 (e-mail: wardm{at}mail.nih.gov).

Received for publication April 27, 2007. Accepted for publication September 1, 2007.

To quantify nonresponse bias and estimate its potential impact, the authors compared census-based socioeconomic and demographic factors and geographic locations among respondents and nonrespondents in a multicenter case-control study of non-Hodgkin lymphoma (1998–2000). Using a geographic information system, the authors mapped current addresses and linked them to the 2000 US Census database to determine group-level demographic and socioeconomic information. They used logistic regression analysis to compute the risk of being a nonrespondent, separately for cases and controls. They used spatial scan methods to evaluate spatial clustering at each study center. Among cases at one or more centers, nonresponse was significantly associated with non-White race, lower household income, a greater proportion of multiple-unit housing, fewer years of education, and living in a more urbanized area. For most factors, the authors observed similar patterns among controls, although findings were mostly nonsignificant. They found two nonrandom elliptical clusters in Los Angeles, California, and Detroit, Michigan, that disappeared after adjustment for the demographic factors. The authors determined the bias in non-Hodgkin lymphoma risk associated with census-tract educational level by comparing risks among respondents and all subjects. The bias was 8%, indicating that the socioeconomic and demographic differences between respondents and nonrespondents did not result in a large bias in the risk estimate for education.

bias (epidemiology); case-control studies; censuses; epidemiologic methods; geographic information systems; lymphoma, non-Hodgkin


Abbreviations: NCI, National Cancer Institute; NHL, non-Hodgkin lymphoma; SEER, Surveillance, Epidemiology, and End Results


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