Smoking, alcohol, diabetes, obesity, socioeconomic status, and the risk of colorectal cancer in a population-based case–control study

Terry Boyle, Lin Fritschi, Seyed Mehdi Tabatabaei, Kathrin Ringwald, Jane S. Heyworth

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Results: The exposures alcohol, smoking, and diabetes were associated with an increased risk of colorectal cancer. We found some differences between cases and controls when examining the factors associated with the participation in the study, and in the sensitivity analyses, the exposure–disease associations were slightly attenuated when compared with those from the original analysis.

Conclusion: Non-participation may have biased the risk estimates away from the null, but generally not enough to change the conclusions of the study.

Purpose: Although previous research has identified factors that may determine willingness to participate in research, relatively few studies have attempted to quantify the impact non-participation may have on exposure–disease associations. The aims of this study were to (a) investigate the associations between smoking, alcohol, diabetes, obesity, and socioeconomic status and the risk of colorectal cancer in a case–control study (59.7 and 47.2 % response fractions among cases and controls, respectively); and (b) perform sensitivity analyses to examine the possible influence of non-participation.

Methods: Logistic regression was used to estimate the exposure–disease associations. We then investigated the associations between various demographic and health factors and the likelihood that an individual would participate in the case–control study and then performed two sensitivity analyses (sampling weights and multiple imputation) to examine whether non-participation bias may have influenced the exposure–disease associations.

Original languageEnglish
Pages (from-to)1659-1668
Number of pages10
JournalCancer Causes and Control
Issue number12
Publication statusPublished or Issued - 18 Nov 2014
Externally publishedYes


  • Alcohol
  • Case–control study
  • Colorectal cancer
  • Participation
  • Response bias
  • Smoking

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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