Estimating the standardized incidence ratio (SIR) with incomplete follow-up data

Becher, Heiko; Winkler, Volker

doi:10.1186/s12874-017-0335-3

Cited by 36 publications

(34 citation statements)

References 5 publications

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“…Registrybased studies often depend on the size, quality, completeness of relevant variables, and features of the registry on which the study is based (75). Furthermore, there are worries about data quality related to end-point measures in registries, and end-point infor-mation such as migration abroad or death from other causes is not always included (76,77). This is a general concern regarding registry-based studies which can only be solved by improving source data.…”

Section: Discussionmentioning

confidence: 99%

Predictors of an Invasive Breast Cancer Recurrence after DCIS: A Systematic Review and Meta-analyses

Visser

Groen

Leeuwen

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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We performed a systematic review with meta-analyses to summarize current knowledge on prognostic factors for invasive disease after a diagnosis of ductal carcinoma in situ (DCIS). Eligible studies assessed risk of invasive recurrence in women primarily diagnosed and treated for DCIS and included at least 10 ipsilateral-invasive breast cancer events and 1 year of follow-up. Quality in Prognosis Studies tool was used for risk of bias assessment. Meta-analyses were performed to estimate the average effect size of the prognostic factors. Of 1,781 articles reviewed, 40 articles met the inclusion criteria. Highest risk of bias was attributable to insufficient handling of confounders and poorly described study groups. Six prognostic factors were statistically signif-icant in the meta-analyses: African-American race [pooled estimate (ES), 1.43; 95% confidence interval (CI), 1.15-1.79], premenopausal status (ES, 1.59; 95% CI, 1.20-2.11), detection by palpation (ES, 1.84; 95% CI, 1.47-2.29), involved margins (ES, 1.63; 95% CI, 1.14-2.32), high histologic grade (ES, 1.36; 95% CI, 1.04-1.77), and high p16 expression (ES, 1.51; 95% CI, 1.04-2.19). Six prognostic factors associated with invasive recurrence were identified, whereas many other factors need confirmation in welldesigned studies on large patient numbers. Furthermore, we identified frequently occurring biases in studies on invasive recurrence after DCIS. Avoiding these common methodological pitfalls can improve future study designs.

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Section: Discussionmentioning

confidence: 99%

Predictors of an Invasive Breast Cancer Recurrence after DCIS: A Systematic Review and Meta-analyses

Visser

Groen

Leeuwen

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Further, the incomplete follow-up of the AMIN cohort and consequently, the estimated person-years of the cohort have to be mentioned. However, the applied estimation procedure was found to be valid and reliable ( 21 ). Even though sensitivity analyses on out-migration showed only minor differences in SIRs (data not shown), some uncertainty remains regarding the assumptions on out-migration and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Since vital status could not be assessed with the follow-up procedure used for the AMOR cohort (described below), person-time was estimated based on an approach for cohorts with an incomplete follow-up ( 21 ). In brief, person-time of each individual was first calculated between date of immigration and date of diagnosis or 31st of December 2013 (end of follow-up).…”

Section: Methodsmentioning

confidence: 99%

Cancer Incidence and Mortality Among Ethnic German Migrants From the Former Soviet Union

Kaucher

Kajüter²,

Becher

et al. 2018

Front. Oncol.

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Germany is a country known for immigration. In 2015, 21% of the general population in Germany consisted of individuals with a migration background. This article focuses on cancer-specific incidence and mortality among one of the biggest migrant groups in Germany: the resettlers. Resettlers are ethnic Germans who mainly immigrated from the Russian federation and other countries of the former Soviet Union after its collapse in 1989. We investigated differences between resettlers and the general German population, regarding (i) incidence and mortality of malignant neoplasms, (ii) time trends of the corresponding incidence and mortality, and (iii) cancer stage at diagnosis. We provide data from two resettler cohorts covering an observation time of 20 years: one cohort on cancer incidence (N = 32,972), and another cohort on mortality (N = 59,390). Cancer-specific standardized incidence ratios (SIR) and standardized mortality ratios (SMR) for all malignant neoplasms combined and the most common cancer-sites were calculated between resettlers and the general German population. Time trend analyses using Poisson regression were performed to investigate the developments of SIRs and SMRs. To investigate differences in stage at diagnosis, logistic regression was performed, calculating Odds Ratios for condensed cancer stages. We observed higher incidence and mortality of stomach cancer [SIR (men) 1.62, 95%CI 1.17–2.19; SMR (men) 1.62, 95%CI 1.31–2.01; SIR (women) 1.32, 95%CI 0.86–1.94; SMR (women) 1.52, 95%CI 1.19–1.93] and higher mortality of lung cancer [SMR (men) 1.34, 95%CI 1.20–1.50] among resettlers compared to the general German population, but lower incidence and mortality of colorectal (both sexes), lung (women), prostate and female breast cancer. However, time trend analyses showed converging incidence risks of cause-specific incidence over time, whereas differences of mortality did not show changes over time. Results from logistic regression suggest that resettler men were more often diagnosed with advanced cancer stages compared to the Münster population. Our findings suggest that risk factor patterns of the most common cancer-sites among resettlers are similar to those observed within the Russian population. Such increases in prostate, colorectal and breast cancer incidence may be the consequence of improved detection measures, and/or the adaptation of resettlers to the German lifestyle.

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“…The cohort includes a sample of resettlers who immigrated to the AD Münster between 1990 and 2001 and were identified with the help of local registration offices. Person-years were estimated using a validated procedure for cohort studies with an incomplete follow-up [22]. Incidence data as well as population figures of the general population in the AD Münster were available from the federal cancer registry of NRW.…”

Section: Study Populationsmentioning

confidence: 99%

“…Furthermore, the number of 50 to 69-year old resettler women with a breast cancer diagnosis was very low in the AMIN cohort, thus, the results from the analysis of the cancer stages should be treated with caution. In the AMIN cohort, it was not possible to perform a mortality follow-up, therefore, person-years of the cohort were estimated [22]. However, sensitivity analyses showed negligible differences in the results.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Breast cancer incidence and mammography screening among resettlers in Germany

Kaucher

Khil²,

Kajüter³

et al. 2020

BMC Public Health

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Background: European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. Methods: Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. Results: Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. Conclusions: MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.

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Estimating the standardized incidence ratio (SIR) with incomplete follow-up data

Cited by 36 publications

References 5 publications

Predictors of an Invasive Breast Cancer Recurrence after DCIS: A Systematic Review and Meta-analyses

Predictors of an Invasive Breast Cancer Recurrence after DCIS: A Systematic Review and Meta-analyses

Cancer Incidence and Mortality Among Ethnic German Migrants From the Former Soviet Union

Breast cancer incidence and mammography screening among resettlers in Germany

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