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000291255 041__ $$aEnglish
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000291255 1001_ $$aMaldonado-Cañón, Kevin$$b0
000291255 245__ $$aThe Healthy Participant Effect: insights and results from a population-based case-control study on breast cancer.
000291255 260__ $$aOxford$$bOxford Univ. Press$$c2025
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000291255 500__ $$aVolume 194, Issue 4, April 2025, Pages 1058–1064
000291255 520__ $$aAgreement to participate in case-control studies has become low. Healthy participant bias resulting from differential response proportions in cases and controls can distort results; however, the magnitude of bias is difficult to assess. We investigated the effect in a large population-based case-control study on breast cancer, with a participation rate of 43.4% and 64.1% for controls and cases. We performed a mortality follow-up in 2020 for 3,813 cases and 7,335 controls recruited between 2002-2005. Standardized mortality ratios (SMR) for overall mortality and selected causes of death were estimated. The mean age at recruitment was 63.1 years. The overall mortality for controls was 0.66 times lower (95%CI 0.62-0.69) than for the reference population. For causes of death other than breast cancer, SMRs were similar in cases and controls (0.70 and 0.64). Higher education was associated with lower SMRs in both cases and controls. Options for adjusting the healthy participant bias are limited if the true risk factor distribution in the underlying population is unknown. However, a relevant bias in this particular case-control study is considered unlikely since a similar healthy participant effect was observed for both controls and cases.
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000291255 650_7 $$2Other$$aBreast Cancer
000291255 650_7 $$2Other$$aCase-control Study
000291255 650_7 $$2Other$$aHealthy Participant Effect
000291255 650_7 $$2Other$$aStandardized Mortality Ratio
000291255 7001_ $$aMöhl, Annika$$b1
000291255 7001_ $$aObi, Nadia$$b2
000291255 7001_ $$aBehrens, Sabine$$b3
000291255 7001_ $$aFlaßkamp, Fabian$$b4
000291255 7001_ $$0P:(DE-He78)fd17a8dbf8d08ea5bb656dfef7398215$$aSeibold, Petra$$b5$$udkfz
000291255 7001_ $$0P:(DE-He78)c259d6cc99edf5c7bc7ce22c7f87c253$$aChang-Claude, Jenny$$b6$$udkfz
000291255 7001_ $$aBecher, Heiko$$b7
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