Health Outcomes

The AHS regularly links the cohort to State Vital Statistics and Cancer Registries to update mortality from all causes and cancer incidence. Other health endpoints are collected by self-report in periodic follow-up questionnaires. Specific health endpoints of interest are confirmed through additional participant contact, review of medical records, and, as required, clinical exam.

Table 2a: Post-enrollment (Incident only) Malignant Cancer Cases by Site and Data Collection Progress 1,2,3,4,5
Cancer Site Total with Cancer Completed Phase II Completed Phase III Returned Buccal Sample Returned DHQ
Bladder 758 526 383 354 336
Brain 220 123 77 81 75
Breast 2,347 1,734 1,472 1,120 1,105
Bronchus and Lung 1,933 1,154 737 610 634
Colon 1,299 880 607 557 520
Head and Neck 167 97 63 56 47
Kaposi Sarcoma 1 1 1 - -
Kidney and Renal Pelvis 683 414 316 260 243
Leukemia 555 351 245 232 206
Liver and Intrahepatic Bile Ducts 173 102 70 46 57
Melanoma 975 665 503 379 382
Mesothelioma 33 13 10 6 5
Multiple Myeloma 310 213 137 126 121
NHL 816 551 418 412 328
Oral 377 266 191 159 164
Ovary 203 142 101 78 80
Pancreas 442 265 185 130 140
Prostate 4,252 2,966 2,262 2,223 1,731
Rectum and Rectosigmoid Junction 498 332 225 208 196
Stomach 203 121 85 73 72
Thyroid Gland 328 219 170 137 116
Uterine 569 416 354 223 253
Other 1,525 1,005 703 574 597
All 18,667 12,556 9,315 8,044 7,408

1 Cancer counts are based on complete registry data through 2017 for Iowa cases and through 2016 for North Carolina cases.

2 Subjects previously diagnosed with cancer at a different site are included.

3 Buccal cell receipts represent progress through 2014.

4 The 'Other' category includes in-situ bladder cancers.

5 SEER Site Recode ICD-O-3 (1/27/2003) Definition used for classifying cancers.


Table 2b: Pre- and Post-enrollment (Prevalent and Incident) Malignant Cancer Cases by Site and Data Collection progress 1,2,3,4,5
Cancer Site Total with Cancer Completed Phase II Completed Phase III Returned Buccal Sample Returned DHQ
Bladder 839 573 413 383 363
Brain 239 135 83 88 82
Breast 2,804 2,080 1,715 1,356 1,357
Bronchus and Lung 1,989 1,180 753 627 651
Colon 1,443 965 669 622 577
Head and Neck 185 107 70 63 54
Kaposi Sarcoma 1 1 1 - -
Kidney and Renal Pelvis 722 438 335 276 256
Leukemia 610 385 263 253 230
Liver and Intrahepatic Bile Ducts 176 103 71 47 58
Melanoma 1,102 756 571 435 443
Mesothelioma 33 13 10 6 5
Multiple Myeloma 323 219 139 131 125
NHL 921 612 450 454 376
Oral 434 303 211 184 191
Ovary 253 179 123 106 106
Pancreas 453 268 185 130 141
Prostate 4,683 3,240 2,419 2,390 1,929
Rectum and Rectosigmoid Junction 583 384 263 247 234
Stomach 210 123 86 74 73
Thyroid Gland 425 297 236 189 169
Uterine 662 485 411 263 301
Other 1,704 1,123 787 643 670
All 20,794 13,969 10,264 8,967 8,391

1 Cancer counts are based on complete registry data through 2017 for Iowa cases and through 2016 for North Carolina cases.

2 Subjects previously diagnosed with cancer at a different site are included.

3 Buccal cell receipts represent progress through 2014.

4 The 'Other' category includes in-situ bladder cancers.

5 SEER Site Recode ICD-O-3 (1/27/2003) Definition used for classifying cancers.


Table 3: Cause Specific Mortality of AHS Cohort, 1994-2017
Cause Frequency Percent Cumulative Frequency Cumulative Percent
Accidents 839 5.01 839 5.01
Cancer 5,254 31.39 6,093 36.40
Cerebrovascular Disease 908 5.42 7,001 41.82
Diabetes Mellitus 435 2.60 7,436 44.42
Heart Disease 4,488 26.81 11,924 71.23
Respiratory Disease 1,417 8.46 13,341 79.70
Other 3,399 20.30 16,740 100.00

Table 4: Medical Conditions asked about in Phase II 1
Private Applicators
N=52,394
Spouses
N=32,346
Commercial Applicators
N=4,916
Total
N=89,656
Completed Phase II Questionnaire 33,457 23,796 2,885 60,138
Cardiovascular Disease
Heart Attack (Myocardial Infarction) 1,789 370 122 2,281
Irregular Heart Beat (Arrhythmia) 3,267 2,571 243 6,081
High Blood Pressure or Hypertension 8,637 5,954 870 15,461
Endocrine Disorder
Diabetes or High Blood Sugar 2,429 1,314 188 3,931
Thyroid Disease or Thyroid Problems 1,075 2,947 90 4,112
Overactive Thyroid (Hyperthyroidism) 279 659 N/A 4 938
Graves Disease 62 151 N/A 4 213
Underactive Thyroid (Hypothyroidism) 528 1,792 55 2,375
Thyroiditis, Hashimoto's Disease, Autoimmune Disease 31 212 N/A 4 243
Enlarged Thyroid, Thyroid Nodules, Goiter 204 997 N/A 4 1,201
Other Thyroid Problem 113 169 N/A 4 282
Women's Health Disorder
Endometriosis N/A 2 1,694 N/A 2 1,694
Uterine Fibroids N/A 2 3,514 N/A 2 3,514
Benign Breast Disease (Fibroids, Cysts, Other) N/A 2 4,060 N/A 2 4,060
Pregnancy Induced High Blood Pressure,
Pre-Eclampsia, Toxemia or Eclampsia
N/A 2 103 N/A 2 103
Gestational Diabetes N/A 2 77 N/A 2 77
Autoimmune/Musculoskeletal Disorders
Rheumotoid Arthritis N/A 2 908 N/A 2 908
Lupus (SLE) N/A 2 110 N/A 2 110
Sjogren's Disease N/A 2 43 N/A 2 43
Scleroderma or Systemic Sclerosis N/A 2 32 N/A 2 32
Kidney Disorder
Kidney Stones 3,862 1,279 200 5,341
Kidney Disease or Kidney Failure 354 214 28 596
Digestive Disorder
Inflammatory Bowel Disease
(Chron's Disease, Ulcerative Colitis)
430 514 41 985
Skin Disorder
Vitiligo 130 84 N/A 4 214
Eczema 719 1,124 89 1,932
Psoriasis 821 582 76 1,479
Allergy to Bees, Wasps, or Other Insects 1,735 1,120 158 3,013
Optical or Hearing Disorder
Blindness 619 271 36 926
Nearsightedness 12,237 13,244 1,345 26,826
Farsightedness 13,683 11,673 1,217 26,573
Cataracts 3,427 2,965 199 6,591
Glaucoma 680 492 49 1,221
Detached Retina 358 179 30 567
Retinal or Macular Degeneration 391 368 34 793
Hearing Problems 11,781 N/A 3 913 12,694
Injury
Head Injury 6,623 1,556 726 8,905
Neck, Back, Spinal Cord Injury 6,250 2,198 588 9,036
Post-Polio Syndrome, Leg Injury 4,344 1,474 188 6,006
Neurologic Disorder
Epilepsy 123 127 N/A 4 250
Multiple Sclerosis 39 83 N/A 4 122
Parkinson's Disease 89 29 N/A 4 118
Tremor (Essential, Familial, Benign) 144 113 N/A 4 257

1 Numbers represent medical conditions reported during Phase II interviews. Because the asking of some questions was dependent on responses to earlier questions, the counts in this table reflect the numbers of each condition reported but not the total occurrence of the diseases in the cohort.

2 These conditions marked with N/A were not asked about in the men's health questions. Since 96 percent of private applicators and commercial applicators in the cohort are men, it would be misleading to report counts for these conditions in the private applicator column.

3 Hearing problems were not asked about in the women's health questions. Since 99.5 percent of spouses in the cohort are women, it would be misleading to report hearing problem counts in the spouse column.

4 These conditions occur in commercial applicators in insufficient numbers to be reported at this time.