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Mortality among participants and non-participants in a prospective cohort study

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Abstract

Socioeconomic position and lifestyle often affect participation in scientific studies. The authors investigated differences in overall and cause-specific mortality between participants and non-participants in the prospective Danish cohort study “Diet, Cancer and Health” and the association between non-participation and mortality by socioeconomic position. A total of 80,996 men and 79,729 women aged 50–64 years, were invited. The authors obtained register data on education, income, death and cause-specific mortality for participants and non-participants and used survival curves to examine differences in overall mortality. Poisson regression models were used to estimate the mortality rate ratio (MRR) by socioeconomic group and by cause of death of participants and non-participants. After a median follow-up of 13 years (5–95 percentiles, 5–14 years), the MRRs for overall mortality among non-participants were 2.09 (95 % CI 1.99–2.14) and 2.29 (95 % CI 2.19–2.40) among men and women, respectively compared with participants. After adjusting for socioeconomic position, the MRRs changed to 1.73 (95 % CI 1.66–1.79) and 2.10 (95 % CO 2.01–2.20) among men and women, respectively. The MRRs did not level out after up to 15 years of follow-up. The MRRs were all significantly increased and ranged from 1.51 to 4.28 for men, depending on the cause of death, and from 1.60 to 3.99 for women. Clear differences in mortality from all investigated causes of death were found between participants and non-participants, which persisted after up to 15 years of follow-up. Socioeconomic position had little effect on this result.

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Acknowledgments

We thank Katja Boll for technical support. The “Diet, Cancer and Health” study was established by Anne Tjønneland and Kim Overvad in 1993–1995 and funded by the Danish Cancer Society. This work was supported by the Health Insurance Foundation grant no. 2006B95 and the Danish Cancer Society Scientific Committee grant no. DP06035.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark

    Signe Benzon Larsen, Susanne Oksbjerg Dalton, Jane Christensen, Anne Tjønneland, Christoffer Johansen & Anja Olsen

  2. Section of Environment and Radiation, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon Cedex 08, France

    Joachim Schüz

  3. Department of Epidemiology, School of Public Health, Aarhus University, Bartholins Allé 2, 8000, Århus, Denmark

    Kim Overvad

  4. Department of Cardiology, Aalborg Hospital, Aarhus University Hospital, Sdr. Skovvej 15, 9000, Ålborg, Denmark

    Kim Overvad

Authors
  1. Signe Benzon Larsen
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  2. Susanne Oksbjerg Dalton
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  3. Joachim Schüz
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  4. Jane Christensen
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  5. Kim Overvad
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  6. Anne Tjønneland
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  7. Christoffer Johansen
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  8. Anja Olsen
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Corresponding author

Correspondence to Signe Benzon Larsen.

Appendix: Supplementary data

Appendix: Supplementary data

Table 6 describes grouped causes of death according to the ICD-10 system.

Table 6 Grouping of specific causes of death according to the ICD-10 system
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Larsen, S.B., Dalton, S.O., Schüz, J. et al. Mortality among participants and non-participants in a prospective cohort study. Eur J Epidemiol 27, 837–845 (2012). https://doi.org/10.1007/s10654-012-9739-x

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  • DOI: https://doi.org/10.1007/s10654-012-9739-x

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