Determinants of Loss to Follow-Up in a Socio-Demographically Diverse Cohort of Prostate Cancer Patients. Public
Panda, Ajay (Spring 2023)
Published
Abstract
Background: Research on patients living with prostate cancer is typically done through prospective longitudinal cohort studies. Analyses investigating the magnitude and sources of loss of follow up improve understanding the role of selection bias in this type of studies.
Methods: African-American and Non-Hispanic White males ≤75 years of age newly diagnosed with low risk prostate cancer were identified in metro-Detroit and State of Georgia population-based cancer registries. The participants were asked to complete baseline, 2-year, and 5-year follow-up surveys. Log-binomial models were used to examine the associations between various sociodemographic factors and loss to follow up with results expressed as risk ratios (RR) and 95% confidence intervals (CI)
Results: Among 1687 study participants, 1161 (68.8%) completed at least one follow up survey, and of those 714 (61.5%) completed all of the surveys. The most consistent factor inversely associated with study drop out was income. Compared to men with annual income of <$30,000 the RR (95% CI) estimates among those reporting income of >$90,000 were 0.63 (CI:0.49-0.81) for any loss to follow and 0.75 (0.59-0.96) for incomplete follow up. Loss of follow up was also less likely in metro Detroit than in the State of Georgia. In the analyses stratified by race, African Americans were significantly less likely (RR=0.65; 95% CI: 0.47-0.89) to have incomplete follow up, if their first course of treatment included tumor directed therapy (surgery or radiation) versus conservative approach (active surveillance or watchful waiting. By contrast, among Non-Hispanic Whites the same association was in the opposite direction (RR=1.33; 95% CI: 1.12-1.58).
Conclusions: These results show that methods of preventing drop out may need to be customized to different population subgroups, especially persons of lower SES. These observations merit future studies with the focus on comparative effectiveness of various interventions aimed at preventing loss of follow up in cohort studies of prostate cancer patients.
Table of Contents
Introduction………………………………………………………………………………..………1
Methods……………………………………………………………………………………………5
Results……………………………………………………………………………………………..7
Discussion………………………………………………………………………………………..10
References………………………………………………………………………………………..13
Tables…………………………………………………………………………………………….16
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