Abstract
BackgroundWe 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/DesignEligible 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.DiscussionA 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.
Highlights
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
By establishing the cohort within an integrated managed care organization, we have access to rich electronic data sources to supplement clinical data collected by survey and to permit the identification and investigation of other health outcomes including other cancers and other non-cancerous conditions
The cover letter and questionnaire were in the language in which the participant completed the short questionnaire, and the cover letters accompanying the questionnaires were tailored to the participant's specific race/ethnic group and were signed by a well known athletic or political (Latino) figure or by one of the study investigators
Summary
Multiethnic cohort primarily to study prostate cancer etiology and secondarily to study the etiologies of other cancer and non-cancer conditions. By establishing the cohort within an integrated managed care organization, we have access to rich electronic data sources to supplement clinical data collected by survey and to permit the identification and investigation of other health outcomes including other cancers and other non-cancerous conditions. We obtained baseline data from the men using a two-stage mailed survey, and we employed unique recruitment techniques to enrich the cohort with non-white men. With this cohort, we plan to build on previous work and investigate novel hypotheses in the broad area of men's health. This paper is to describe the baseline demographic characteristics, health status, and lifestyle behaviors of the cohort, to estimate expected cases of cancer, to evaluate the validity of the self-reported data, and to examine how representative the cohort was to the larger population
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