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======= Cancer types =======
At [[1a_questionnaire_1|1A]], [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], and [[3a_questionnaire_1|3A]] type of cancer (tumor) was reported by participants in an open text field. From 2A onwards a limited number of cancer types (i.e., colon cancer, lung cancer, skin cancer, brain tumor, bone cancer, breast cancer, and prostate cancer) are also directly assessed via yes/no questions. At [[3b|3B]] only these direct cancer type questions are used, there is no open text field. Researchers from the University Medical Center Groningen coded these [[cancer|self-reported cancer variables]] into 35 cancer type categories. The secondary cancer type variables will be added to the [[https://data-catalogue.lifelines.nl/|Lifelines catalogue]] very soon.
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When the secondary cancer variables have been used in your research, you will have to include a reference to the validation paper.
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  * [[https://doi.org/10.1016/j.clnu.2020.06.016|Cortés-Ibáñez, F.O., et al. The validity of self-reported cancer in a population-based cohort compared to that in formally registered sources. Cancer Epidemiology (2022): 1022-1068.]]
===== Data processing =====
Tumors were coded using the directly assessed cancer variables or terms mentioned in the open text field and categorized according to type, location, and stage. If participants mentioned a term related to metastasis in the open text field an additional cancer metastasis variable was coded as 1. For 1A the coding of all open text fields was checked by an MD/PhD student of the Oncology Epidemiology department. When in doubt a pathologist was asked to make a final decision. If the student or pathologist did not agree with the coding of an open text field, the text field was manually recoded based on their input. From 1B onwards the algorithm and manual correction have been applied by the Lifelines data management team. Only the open text fields that were also recoded at 1A have manually been corrected. Additionally, open text fields that were not coded by the algorithm have manually been coded.

| **Value**  | **Label English**                                                            | **Description**                                                                                                                                                                                               |
| 1          | no cancer reported and open text field is empty                              | contains the participants that indicated not having cancer                                                                                                                                                    |
| 2          | cancer reported and open text field is coded as no cancer                    | contains the participants that indicated having cancer but the researchers did not consider it cancer (e.g., benign growth)                                                                                   |
| 3          | cancer reported and open text field is empty or not present                  | contains the participants that indicated having cancer but the open text field has not been filled in or is not present by design (i.e., assessment 3B; other cancer is yes but there is no open text field)  |
| 4          | cancer reported and open text field is coded as unknown if it is cancer      | contains the participants that indicated having cancer but the researchers were unsure whether is is cancer (e.g., a spot or cyst)                                                                            |
| 5          | cancer reported and open text field is coded as prestage cancer              | contains the participants that indicated having cancer but the researchers considered it prestage cancer                                                                                                      |
| 6          | cancer reported and open text field is coded as cancer but location unknown  | contains the participants that indicated having cancer but the researchers thought it unsure which type (i.e., hormonal cancer)                                                                               |
| 7          | central nervous system cancer including brain tumor                          | contains the participants that mentioned a term related to central nervous system or brain cancer                                                                                                             |
| 8          | head/neck cancer excluding eyes and salivary glands                          | contains the participants that mentioned a term related to head/neck cancer                                                                                                                                   |
| 9          | eye cancer                                                                   | contains the participants that mentioned a term related to eye cancer                                                                                                                                         |
| 10         | salivary gland cancer                                                        | contains the participants that mentioned a term related to salivary gland cancer                                                                                                                              |
| 11         | oesophageal cancer                                                           | contains the participants that mentioned a term related to oesophageal cancer                                                                                                                                 |
| 12         | stomach cancer                                                               | contains the participants that mentioned a term related to stomach cancer                                                                                                                                     |
| 13         | colorectal cancer                                                            | contains the participants that mentioned a term related to bowel or rectal cancer                                                                                                                             |
| 14         | other digestive tract cancer                                                 | contains the participants that mentioned a term related to digestive tract cancer that did not fit any of the categories                                                                                      |
| 15         | breast cancer                                                                | contains the participants that mentioned a term related to breast cancer                                                                                                                                      |
| 16         | endometrial cancer including cervix                                          | contains the participants that mentioned a term related to endometrial or cervical cancer                                                                                                                     |
| 17         | ovarian cancer including fallopian tubes                                     | contains the participants that mentioned a term related to ovarian cancer                                                                                                                                     |
| 18         | vulvar cancer including vagina                                               | contains the participants that mentioned a term related to vulvar cancer                                                                                                                                      |
| 19         | prostate cancer                                                              | contains the participants that mentioned a term related to prostate cancer                                                                                                                                    |
| 20         | penile cancer                                                                | contains the participants that mentioned a term related to penis cancer                                                                                                                                       |
| 21         | testicular cancer                                                            | contains the participants that mentioned a term related to testicular cancer                                                                                                                                  |
| 22         | skin cancer                                                                  | contains the participants that mentioned a term related to skin cancer                                                                                                                                        |
| 23         | thyroid cancer                                                               | contains the participants that mentioned a term related to thyroid cancer                                                                                                                                     |
| 24         | lung cancer including pleurae                                                | contains the participants that mentioned a term related to lung cancer                                                                                                                                        |
| 25         | liver cancer                                                                 | contains the participants that mentioned a term related to liver cancer                                                                                                                                       |
| 26         | gallbladder cancer including bile ducts                                      | contains the participants that mentioned a term related to gallbladder cancer                                                                                                                                 |
| 27         | pancreatic cancer                                                            | contains the participants that mentioned a term related to pancreatic cancer                                                                                                                                  |
| 28         | bladder cancer including urinary tract                                       | contains the participants that mentioned a term related to bladder cancer                                                                                                                                     |
| 29         | kidney cancer including adrenal glands                                       | contains the participants that mentioned a term related to kidney or adrenal cancer                                                                                                                           |
| 30         | endocrine cancer                                                             | contains the participants that mentioned a term related to endocrine cancer                                                                                                                                   |
| 31         | bone and soft tissue cancer                                                  | contains the participants that mentioned a term related to bone or soft tissue cancer                                                                                                                         |
| 32         | leukemia                                                                     | contains the participants that mentioned a term related to leukemia                                                                                                                                           |
| 33         | plasma cell cancer                                                           | contains the participants that mentioned a term related to plasma cell cancer                                                                                                                                 |
| 34         | lymphoma                                                                     | contains the participants that mentioned a term related to lymph node cancer                                                                                                                                  |
| 35         | other blood cancer                                                           | contains the participants that mentioned a term related to blood cancer that did not fit any of the other categories                                                                                          |
===== Validation =====
The data processing described above was validated by Cortés-Ibáñez //et al. 2022// on the 1A data.

=== From the abstract of Cortés-Ibáñez et al. 2022 ===

//Results//
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6611 (4.50%) participants had at least one self-reported diagnosis of cancer, where 9960 (6.97%) participants had at least one cancer diagnosis in PALGA. The sensitivity of self-reported cancer was 64.68% [95%CI:63.71–65.66], and 70.18% [95%CI:68.83–71.56] after excluding skin and cervical cancers. Skin and cervical cancers represented 61.24% of non-self-reported cancers. The overall positive predictive value was 97.45% [95%CI:97.45–97.81], and 97.33% [95%CI:96.72–97.82] after the exclusion of skin and cervical cancers. Participants who did not self-report their cancer were more likely to be male, had longer time since diagnosis and lower educational level.
Besides the different sum scores, the number of valid items is provided. Enabling everyone to decide how many valid answers is enough to include a sum score.
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//Conclusion//
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Overall, the reports of cancer in Lifelines have a high positive predictive value and moderate sensitivity. One third of the cancers were not reported, mainly skin and cervical cancers. Male participants, those with a lower educational level and those with longer time since diagnosis were less likely to self-report a diagnosed cancer.
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===== Variables =====
| **Label English**                                                                                     | **Label Dutch**                                                                                         | **Code**                      | **Variable**      | **Assessment**                                                                                         | **Age**  |
| participant reported having or having had this first type of cancer                                   | deelnemer zegt dit eerste type kanker te hebben of te hebben gehad                                      | cancertype_lifetime_adu_c_01  | cancerlifetime1   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported having or having had this second type of cancer                                  | deelnemer zegt dit tweede type kanker te hebben of te hebben gehad                                      | cancertype_lifetime_adu_c_02  | cancerlifetime2   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported having or having had this third type of cancer                                   | deelnemer zegt dit derde type kanker te hebben of te hebben gehad                                       | cancertype_lifetime_adu_c_03  | cancerlifetime3   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported having or having had this fourth type of cancer                                  | deelnemer zegt dit vierde type kanker te hebben of te hebben gehad                                      | cancertype_lifetime_adu_c_04  | cancerlifetime4   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported having or having had this fifth type of cancer                                   | deelnemer zegt dit vijfde type kanker te hebben of te hebben gehad                                      | cancertype_lifetime_adu_c_05  | cancerlifetime5   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported having or having had this sixth type of cancer                                   | deelnemer zegt dit zesde type kanker te hebben of te hebben gehad                                       | cancertype_lifetime_adu_c_06  | cancerlifetime6   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported having or having had this seventh type of cancer                                 | deelnemer zegt dit zevende type kanker te hebben of te hebben gehad                                     | cancertype_lifetime_adu_c_07  | cancerlifetime7   | [[1a_questionnaire_1|1A]]                                                                              | 18+      |
| participant reported getting this first type of cancer since filling in the previous questionnaire    | deelnemer zegt dit eerste type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst   | cancertype_followup_adu_c_01  | cancerfollowup1   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| participant reported getting this second type of cancer since filling in the previous questionnaire   | deelnemer zegt dit tweede type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst   | cancertype_followup_adu_c_02  | cancerfollowup2   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| participant reported getting this third type of cancer since filling in the previous questionnaire    | deelnemer zegt dit derde type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst    | cancertype_followup_adu_c_03  | cancerfollowup3   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| participant reported getting this fourth type of cancer since filling in the previous questionnaire   | deelnemer zegt dit vierde type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst   | cancertype_followup_adu_c_04  | cancerfollowup4   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| participant reported getting this fifth type of cancer since filling in the previous questionnaire    | deelnemer zegt dit vijfde type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst   | cancertype_followup_adu_c_05  | cancerfollowup5   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| participant reported getting this sixth type of cancer since filling in the previous questionnaire    | deelnemer zegt dit zesde type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst    | cancertype_followup_adu_c_06  | cancerfollowup6   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| participant reported getting this seventh type of cancer since filling in the previous questionnaire  | deelnemer zegt dit zevende type kanker te hebben gekregen sinds het invullen van de vorige vragenlijst  | cancertype_followup_adu_c_07  | cancerfollowup7   | [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]], [[3b|3B]]                  | 18+      |
| terms mentioning metastasis identified in the open text field                                         | term die verwijst naar uitzaaingen geïdentificeerd in het open tekstveld                                | cancer_metastasis_adu_c_1     | cancermetastasis  | [[1a_questionnaire_1|1A]], [[1b|1B]], [[1c|1C]], [[2a_questionnaire_1|2A]], [[3a_questionnaire_1|3A]]  | 18+      |