California Men's Health Study (CMHS): a multiethnic cohort in a managed care setting.
BACKGROUND
We established a male, multiethnic cohort primarily to study prostate cancer etiology and secondarily to study the etiologies of other cancer and non-cancer conditions.


METHODS
Eligible participants were 45-to-69 year old males who were members of a large, prepaid health plan in California. Participants completed two surveys on-line or on paper in 2002-2003. Survey content included demographics; family, medical, and cancer screening history; sexuality and sexual development; lifestyle (diet, physical activity, and smoking); prescription and non-prescription drugs; and herbal supplements. We linked study data with clinical data, including laboratory, hospitalization, and cancer data, from electronic health plan files. We recruited 84,170 participants, approximately 40% from minority populations and over 5,000 who identified themselves as other than heterosexual. We observed a wide range of education (53% completed less than college) and income. PSA testing rates (75% overall) were highest among black participants. Body mass index (BMI) (median 27.2) was highest for blacks and Latinos and lowest for Asians, and showed 80.6% agreement with BMI from clinical data sources. The sensitivity and specificity can be assessed by comparing self-reported data, such as PSA testing, diabetes, and history of cancer, to health plan data. We anticipate that nearly 1,500 prostate cancer diagnoses will occur within five years of cohort inception.


CONCLUSIONS
A wide variety of epidemiologic, health services, and outcomes research utilizing a rich array of electronic, biological, and clinical resources is possible within this multiethnic cohort. The California Men's Health Study and other cohorts nested within comprehensive health delivery systems can make important contributions in the area of men's health.
Enger
Shelley M
SM
Department of Research & Evaluation, Kaiser Permanente Medical Care Program, Pasadena, CA 91188, USA. shelleyenger@yahoo.com
Van den Eeden
Stephen K
SK
Sternfeld
Barbara
B
Loo
Ronald K
RK
Quesenberry
Charles P
CP
Rowell
Sarah
S
Sadler
Marianne C
MC
Schaffer
Donna M
DM
Habel
Laurel A
LA
Caan
Bette J
BJ
D000368:Aged; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017061:Prepaid Health Plans; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology*; D012309:Risk-Taking; D011795:Surveys and Questionnaires
D017430:Prostate-Specific Antigen