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The importance of full participation: lessons from a national case-control study

Law, G.R., Smith, A.G. and Roman, E. (2002) The importance of full participation: lessons from a national case-control study. British Journal of Cancer, 86 (3). pp. 350-355. ISSN 0007-0920


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Differential participation between cases and controls can lead to biased estimates of risk. However, the effects of participation are often ignored. We report a detailed analysis of locations of residence for participants and non-participants in a large, national case–control study of childhood cancer in Great Britain, using the 1991 census. The initial selection of 7669 controls, taken from lists of those registered with a General Practitioner, was representative of the British population in respect to an areal-based index of material deprivation. However, parents of controls agreeing to participate were living in more affluent areas than initially selected controls and their matched 3838 cases. The three components of the deprivation index, persons unemployed, households not owning a car or their home were similarly associated with participation. Other census characteristics, such as proportion of flat dwellers and centrally heated households were also associated with control participation. Population density of the local area was not different between participating controls and their matched cases. However, initially selected controls lived in more urban areas than their cases. Such differences are not unique to this study, as they are an inevitable consequence of incomplete participation. The implications of these differences are discussed, in relation to the difficulty this imposes in the interpretation of studies of disease aetiology.

Item Type: Article
Keywords: childhood cancer, aetiology, census, participation, case-control
Institution: The University of York
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds)
The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Genetics, Health and Therapeutics (LIGHT)
The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 17 Aug 2009 15:20
Last Modified: 18 Jun 2015 17:27
Published Version: http://dx.doi.org/10.1038/sj.bjc.6600092
Status: Published
Publisher: Nature Publishing Group
Identification Number: 10.1038/sj.bjc.6600092
URI: http://eprints.whiterose.ac.uk/id/eprint/5702

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