No evidence of response bias in a population-based childhood cancer survivor questionnaire survey - Results from the Swiss Childhood Cancer Survivor Study

Corina S Rueegg, Micòl E Gianinazzi, Gisela Michel, Marcel Zwahlen, Nicolas X von der Weid, Claudia E Kuehni, and the Swiss Paediatric Oncology Group (SPOG), Corina S Rueegg, Micòl E Gianinazzi, Gisela Michel, Marcel Zwahlen, Nicolas X von der Weid, Claudia E Kuehni, and the Swiss Paediatric Oncology Group (SPOG)

Abstract

Purpose: This is the first study to quantify potential nonresponse bias in a childhood cancer survivor questionnaire survey. We describe early and late responders and nonresponders, and estimate nonresponse bias in a nationwide questionnaire survey of survivors.

Methods: In the Swiss Childhood Cancer Survivor Study, we compared characteristics of early responders (who answered an initial questionnaire), late responders (who answered after ≥1 reminder) and nonresponders. Sociodemographic and cancer-related information was available for the whole population from the Swiss Childhood Cancer Registry. We compared observed prevalence of typical outcomes in responders to the expected prevalence in a complete (100% response) representative population we constructed in order to estimate the effect of nonresponse bias. We constructed the complete population using inverse probability of participation weights.

Results: Of 2328 survivors, 930 returned the initial questionnaire (40%); 671 returned the questionnaire after ≥1reminder (29%). Compared to early and late responders, we found that the 727 nonresponders (31%) were more likely male, aged <20 years, French or Italian speaking, of foreign nationality, diagnosed with lymphoma or a CNS or germ cell tumor, and treated only with surgery. But observed prevalence of typical estimates (somatic health, medical care, mental health, health behaviors) was similar among the sample of early responders (40%), all responders (69%), and the complete representative population (100%). In this survey, nonresponse bias did not seem to influence observed prevalence estimates.

Conclusion: Nonresponse bias may play only a minor role in childhood cancer survivor studies, suggesting that results can be generalized to the whole population of such cancer survivors and applied in clinical practice.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Study design and response behavior…
Fig 1. Study design and response behavior in the Swiss Childhood Cancer Survivor Study.
The different procedures of the Swiss Childhood Cancer Survivor Study and the number of participants in each step of the study.
Fig 2. Comparison of self-reported outcomes between…
Fig 2. Comparison of self-reported outcomes between early responders, late responders, and a constructed complete population of the Swiss Childhood Cancer Survivor Study.
Proportions and 95% confidence intervals for typical self-reported outcomes for somatic health, medical care, mental health, and health behaviors, comparing the observed prevalence from early responders (designated with a white diamond) and all responders (designated with a grey diamond) of the SCCSS with the expected prevalence in the representative complete population (designated with a black diamond). We constructed the complete population with inverse probability of participation weights (S1 File) (22). S1 Table describes how each of the outcomes compared was assessed and classified. Abbreviations: BMI, Body Mass Index; SCCSS, Swiss Childhood Cancer Survivor Study.

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Source: PubMed

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