Factors associated with dropout in a lung cancer high‑risk cohort--the Liverpool lung project.
In long-term longitudinal cohort studies the dropout of participants occurring as a result of withdrawal or lost to follow-up may have greater impact on the effect estimates, if characteristics of participants who drop out and those still active in the study differ significantly. The study aimed to investigate factors associated with dropout in a 5-year follow-up of individuals at 'high‑risk' of lung cancer. We studied 'high‑risk' group of 1,486 individuals aged 45-79 selected from the Liverpool Lung Prospective (LLP) cohort study using a strategy reflecting only age, smoking duration and history of pulmonary disease. Study subjects were recalled annually from 2005-2009 for follow-up collection of specimens and questionnaire data. The dropout rate over the follow-up time was investigated using the Kaplan‑Meier survival curve and the Cox proportional hazard model. Dropout rate was 31% after an average of 3 annual visits. Female gender hazard ratio (HR) 1.35 (95% CI 1.09-1.66), current smoking 1.26 (1.02-1.57), prior diagnosis of malignant disease 0.54 (0.36-0.79), home visits 0.67 (0.48-0.94) and systolic blood pressure 1.46 (1.10-1.94) were significantly associated with the dropout rate. Nearly 40% of individuals selected into the 'high‑risk' group by the old criteria were low risk with predicted 5-year absolute risk of less than 2.5%. In conclusion, follow-up of individuals is feasible within the LLP, but may be prone to selective withdrawal attributable to patient's state of health and mobility. We recommend future design of 'high‑risk' follow‑up studies to consider home visit as a useful strategy to encourage continued participation.
Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Institute of Translational Medicine, The University of Liverpool, Liverpool L3 9TA, UK.
Michael W
MW
Marcus
Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Institute of Translational Medicine, The University of Liverpool, Liverpool L3 9TA, UK.
Olaide Y
OY
Raji
Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Institute of Translational Medicine, The University of Liverpool, Liverpool L3 9TA, UK.
Ying
Y
Chen
Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, UK.
Stephen W
SW
Duffy
Roy Castle Lung Cancer Research Programme, The University of Liverpool Cancer Research Centre, Institute of Translational Medicine, The University of Liverpool, Liverpool L3 9TA, UK.
John K
JK
Field
D000368:Aged; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects