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@ARTICLE{MaldonadoCan:291255,
author = {K. Maldonado-Cañón and A. Möhl and N. Obi and S. Behrens
and F. Flaßkamp and P. Seibold$^*$ and J. Chang-Claude$^*$
and H. Becher},
title = {{T}he {H}ealthy {P}articipant {E}ffect: insights and
results from a population-based case-control study on breast
cancer.},
journal = {American journal of epidemiology},
volume = {194},
number = {4},
issn = {0096-5294},
address = {Oxford},
publisher = {Oxford Univ. Press},
reportid = {DKFZ-2024-01341},
pages = {1058–1064},
year = {2025},
note = {Volume 194, Issue 4, April 2025, Pages 1058–1064},
abstract = {Agreement 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.},
keywords = {Breast Cancer (Other) / Case-control Study (Other) /
Healthy Participant Effect (Other) / Standardized Mortality
Ratio (Other)},
cin = {C020},
ddc = {610},
cid = {I:(DE-He78)C020-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:38918045},
doi = {10.1093/aje/kwae155},
url = {https://inrepo02.dkfz.de/record/291255},
}