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 618 435 318 320 290
Brain 172 91 52 69 65
Breast 1,693 1,314 1,100 966 915
Bronchus and Lung 1,356 793 436 467 458
Colon 1,067 731 492 490 451
Head and Neck 120 75 50 47 39
Kidney and Renal Pelvis 537 336 247 226 207
Leukemia 447 279 195 201 170
Liver and Intrahepatic Bile Ducts 122 70 42 32 43
Melanoma 744 532 391 317 320
Mesothelioma 29 12 9 6 5
Multiple Myeloma 245 170 103 110 106
NHL 668 449 335 361 282
Oral 289 208 148 133 134
Ovary 156 112 83 65 68
Pancreas 337 199 122 100 110
Prostate 3,734 2,634 2,006 2,083 1,578
Rectum and Rectosigmoid Junction 401 265 178 175 162
Stomach 164 103 70 69 67
Thyroid Gland 256 181 138 121 102
Uterine 428 326 278 183 213
Other 1,167 784 518 476 492
All 14,750 10,099 7,311 7,017 6,277

1 Cancer counts are based on complete registry data through 2017 for Iowa cases and through 2014 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 699 482 348 349 317
Brain 191 103 58 76 72
Breast 2,149 1,659 1,343 1,202 1,167
Bronchus and Lung 1,405 815 449 480 472
Colon 1,211 816 554 555 508
Head and Neck 138 85 57 54 46
Kidney and Renal Pelvis 576 360 266 242 220
Leukemia 502 313 213 222 194
Liver and Intrahepatic Bile Ducts 124 71 43 33 44
Melanoma 871 623 459 373 381
Mesothelioma 29 12 9 6 5
Multiple Myeloma 257 175 105 115 110
NHL 773 510 367 403 330
Oral 345 245 168 158 161
Ovary 206 149 105 93 94
Pancreas 348 202 122 100 111
Prostate 4,161 2,906 2,161 2,249 1,774
Rectum and Rectosigmoid Junction 486 317 216 214 200
Stomach 171 105 71 70 68
Thyroid Gland 352 258 203 172 154
Uterine 520 394 334 223 261
Other 1,343 900 600 545 565
All 16,857 11,500 8,251 7,934 7,254

1 Cancer counts are based on complete registry data through 2017 for Iowa cases and through 2014 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 845 5.02 845 5.02
Cancer 5,274 31.33 6,119 36.35
Cerebrovascular Disease 915 5.44 7,034 41.78
Diabetes Mellitus 435 2.58 7,469 44.37
Heart Disease 4,516 26.83 11,985 71.19
Respiratory Disease 1,426 8.47 13,411 79.66
Other 3,424 20.34 16,835 100.00

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.