Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis

Abstract We analysed cancer risks in patients with urinary tract stones but some features of the generated results alarmed us about possible surveillance bias, which we describe in this report. We used nationwide Swedish hospital records to identify patients with urinary tract stones (N = 211,718) a...

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Autores principales:	Kari Hemminki, Otto Hemminki, Asta Försti, Kristina Sundquist, Jan Sundquist, Xinjun Li
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/48c48949302348feafcee97c5a14547c
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spelling	oai:doaj.org-article:48c48949302348feafcee97c5a14547c2021-12-02T11:40:31ZSurveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis10.1038/s41598-017-08839-52045-2322https://doaj.org/article/48c48949302348feafcee97c5a14547c2017-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-08839-5https://doaj.org/toc/2045-2322Abstract We analysed cancer risks in patients with urinary tract stones but some features of the generated results alarmed us about possible surveillance bias, which we describe in this report. We used nationwide Swedish hospital records to identify patients with urinary tract stones (N = 211,718) and cancer registration data for cancer patients for years 1987 to 2012. Standardized incidence ratios (SIRs) for cancer were calculated after the last medical contact for urinary tract stones. All cancers were increased after kidney (SIR 1.54, 95%CI: 1.50–1.58), ureter (1.44, 1.42–1.47), mixed (1.51, 1.44–1.58) and bladder stones (1.63, 1.57–1.70). The risk of kidney cancer was increased most of all cancers after kidney, ureter and mixed stones while bladder cancer was increased most after bladder stones. All SIRs decreased steeply in the course of follow-up time. Tumour sizes were smaller in kidney cancer and in situ colon cancers were more common in patients diagnosed after urinary tract stones compared to all patients. The results suggest that surveillance bias influenced the result which somewhat surprisingly appeared to extend past 10 years of follow-up and include cancers at distant anatomical sites. Surveillance bias may be difficult to avoid in the present type of observational studies in clinical settings.Kari HemminkiOtto HemminkiAsta FörstiKristina SundquistJan SundquistXinjun LiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-4 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Kari Hemminki Otto Hemminki Asta Försti Kristina Sundquist Jan Sundquist Xinjun Li Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis
description	Abstract We analysed cancer risks in patients with urinary tract stones but some features of the generated results alarmed us about possible surveillance bias, which we describe in this report. We used nationwide Swedish hospital records to identify patients with urinary tract stones (N = 211,718) and cancer registration data for cancer patients for years 1987 to 2012. Standardized incidence ratios (SIRs) for cancer were calculated after the last medical contact for urinary tract stones. All cancers were increased after kidney (SIR 1.54, 95%CI: 1.50–1.58), ureter (1.44, 1.42–1.47), mixed (1.51, 1.44–1.58) and bladder stones (1.63, 1.57–1.70). The risk of kidney cancer was increased most of all cancers after kidney, ureter and mixed stones while bladder cancer was increased most after bladder stones. All SIRs decreased steeply in the course of follow-up time. Tumour sizes were smaller in kidney cancer and in situ colon cancers were more common in patients diagnosed after urinary tract stones compared to all patients. The results suggest that surveillance bias influenced the result which somewhat surprisingly appeared to extend past 10 years of follow-up and include cancers at distant anatomical sites. Surveillance bias may be difficult to avoid in the present type of observational studies in clinical settings.
format	article
author	Kari Hemminki Otto Hemminki Asta Försti Kristina Sundquist Jan Sundquist Xinjun Li
author_facet	Kari Hemminki Otto Hemminki Asta Försti Kristina Sundquist Jan Sundquist Xinjun Li
author_sort	Kari Hemminki
title	Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis
title_short	Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis
title_full	Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis
title_fullStr	Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis
title_full_unstemmed	Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis
title_sort	surveillance bias in cancer risk after unrelated medical conditions: example urolithiasis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/48c48949302348feafcee97c5a14547c
work_keys_str_mv	AT karihemminki surveillancebiasincancerriskafterunrelatedmedicalconditionsexampleurolithiasis AT ottohemminki surveillancebiasincancerriskafterunrelatedmedicalconditionsexampleurolithiasis AT astaforsti surveillancebiasincancerriskafterunrelatedmedicalconditionsexampleurolithiasis AT kristinasundquist surveillancebiasincancerriskafterunrelatedmedicalconditionsexampleurolithiasis AT jansundquist surveillancebiasincancerriskafterunrelatedmedicalconditionsexampleurolithiasis AT xinjunli surveillancebiasincancerriskafterunrelatedmedicalconditionsexampleurolithiasis
_version_	1718395578900021248

Surveillance Bias in Cancer Risk After Unrelated Medical Conditions: Example Urolithiasis

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