Scientific Collaboration

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 567 402 288 294 262
Brain 149 78 39 58 57
Breast 1,498 1,168 963 867 807
Bronchus and Lung 1,127 727 389 424 411
Colon 999 683 448 464 421
Head and Neck 106 61 41 37 30
Kidney and Renal Pelvis 478 301 225 202 189
Leukemia 396 249 168 182 152
Liver and Intrahepatic Bile Ducts 108 62 37 25 38
Melanoma 642 467 334 278 282
Mesothelioma 27 11 8 6 5
Multiple Myeloma 215 148 89 100 95
NHL 593 396 291 325 249
Oral 253 182 130 119 121
Ovary 143 102 76 58 61
Pancreas 287 168 93 81 89
Prostate 3,368 2,366 1,806 1,909 1,420
Rectum and Rectosigmoid Junction 381 251 172 165 153
Stomach 157 99 68 66 64
Thyroid Gland 231 162 126 113 97
Uterine 371 280 239 156 178
Other 1,023 676 436 407 418
All 13,249 9,039 6,466 6,336 5,599

1 Cancer counts are based on nearly complete registry data through 2014 for Iowa and 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.

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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 648 449 318 323 289
Brain 168 90 45 65 64
Breast 1,954 1,513 1,206 1,103 1,059
Bronchus and Lung 1,306 749 402 437 425
Colon 1,143 768 510 529 478
Head and Neck 124 71 48 44 37
Kidney and Renal Pelvis 517 325 244 218 202
Leukemia 451 283 186 203 176
Liver and Intrahepatic Bile Ducts 110 63 38 26 39
Melanoma 769 558 402 334 343
Mesothelioma 27 11 8 6 5
Multiple Myeloma 227 153 91 105 99
NHL 698 457 323 367 297
Oral 309 219 150 144 148
Ovary 193 139 98 86 87
Pancreas 298 171 93 81 90
Prostate 3,795 2,638 1,961 2,705 1,616
Rectum and Rectosigmoid Junction 466 303 210 204 191
Stomach 164 101 69 67 65
Thyroid Gland 327 239 191 164 149
Uterine 463 348 295 196 226
Other 1,199 792 518 476 491
All 15,356 10,440 7,406 7,253 6,576

1 Cancer counts are based on nearly complete registry data through 2014 for Iowa and 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.

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Table 3: Cause Specific Mortality of AHS Cohort, 1994-2015
Cause Frequency Percent Cumulative Frequency Cumulative Percent
Accidents 737 5.13 737 5.13
Cancer 4,637 32.29 5,374 37.42
Cerebrovascular Disease 765 5.33 6,139 42.75
Diabetes Mellitus 356 2.48 6,495 45.23
Heart Disease 3,880 27.02 10,375 72.25
Respiratory Disease 1,189 8.28 11,564 80.53
Other 2,796 19.47 14,360 100.00

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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.

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