Fourth, information on established risk factors of cancer, such as cigarette smoking, alcohol consumption, dietary habits and family history, are not available in the claims data.
As shown in Table 5, most studies failed to fulfill important quality criteria such as individual measures of arsenic exposure using biomarkers, standard criteria to diagnose diabetes, or information on established risk factors for diabetes.
Information on established syndromic surveillance systems was collected from peer-reviewed articles (found in MEDLINE, Scopus and Google Scholar), proceedings from all ISDS Conferences and other conferences and searches through reference lists of papers.
Although we had extensive information on established risk factors for AGT, dietary variables were only available for a subset of women who completed the FFQ at the mid pregnancy interview.
To test if workers from incipient colonies responded to fertility information on established queens in the same manner as workers from large colonies, we presented established queens from large colonies (>1000 workers) to workers from incipient colonies (< 40 workers, N = 9).
Information on established risk factors for pregnancy hypertension and pre-eclampsia that was available for analysis included: maternal age at delivery (<20, 20 34, ≥35 years), nulliparity, Asian ethnicity (based on country of birth), multifetal pregnancy, smoking during pregnancy, summer birth and interpregnancy interval ≥5 years (with lookback to 1994).
Because multiple factors influence breast cancer risk (including many factors that are potentially confounding because they are correlated with demographics that also are related to environmental exposures), building on cohort studies that have already collected information on established risk factors is helpful.
Data were obtained by means of an extensive mailed questionnaire requesting detailed information on established and possible breast cancer risk factors, including reproductive and menstrual history, family history of breast cancer, hormone replacement therapy (HRT) and anthropometric measures, such as body mass index (BMI).
Potential limitations of this study primarily reflect the need to rely on self-report for tobacco and alcohol use and on medical database information for establishing the diagnosis of diabetes, leading to concern for potential misclassification of exposures and outcomes.
Future research should focus on establishing whether information provision is consistent and sufficient across specialties.
