B Age at event/cesoring assignment

Variables’ description

Table B.1: Variables for assigning age at event/censoring
Variables Description Source
a_menslast_overall (some reported years and months) age at last natural menstrual period self-reported in expansion baseline, follow-up 1, 4 and 5 surveys
menarcheage (only in years) menarche age self-reported in expansion baseline, follow-up 1, 4 and 5 surveys
a_SurgicalPM (only in years) age at surgical time self-reported in “SURGICAL PROCEDURES” in expansion baseline, follow-up 4 and 5 surveys
age_dx (exact age) age at primary cancer diagnosis calculated based on the date of cancer diagnosed
age_smn1 (exact age) age at second malignant neoplasm calculated based on the date of second cancer diagnose
age_lastmhr (exact age) age at last survey that contained menstrual history calculated based on the date of the most recent questionnaire contained menstrual history
statusgoli_overall status in original data set from CCSS
a_event new generated age at event


Algorithms

Table B.2: Algorithms for assignment of age at event / censoring
Status Status definition age at event / censoring Notes / Modification
NSPM ovarian function retained
for at least 5 years
following cancer diagnosis,
but menopause before age 40		 age at last menstrual period
If the age at last menstrual was too young
(e.g. age < 9), the record is deemed incorrect.
The subjects will be excluded from analysis.
Surgical PM Surgery was the reason cited
for the onset
of menopause prior age 40		 age at surgical time Some “a_menslast_overall” were much earlier
than “a_SurgicalPM”, they were reclassified as
NSPM or AOF and age at event = “a_menslast_overall”
age at last menstrual period “a_menslast_overall” might occur much earlier than
“a_SurgicalPM”, in which case, they should be NSPM or
AOF. To avoid misclassifying the outcome, they were
excluded depending on the cut-off age for outcomes.
AOF Patient’s menstrual period
stopped permanently within 5
years of cancer diagnosis		 menarche age or age at last
menstrual period or 16, or a_dx + 5		 If a_menslast_overall is missing, we use age at
menarche as the age at event. If both are missing,
we use the maximum of (16, age at diagnosis plus 5).
AOF
no menarche		 Patients reported never
going through
menarche by age 18		 a_dx + 5 or 16 There is no menstrual history to assign age at
event for this group. The maximum of
(age at diagnose + 5, 16) is used.
Normal No indications that periods
ceased prior to age 40 due
to any of the above causes		 age at last survey with
menstrual history or 40		 Extensions of menstrual status beyond age 40 would
require further review of the available data.
age at last menstrual period When this age was greater than 40.
age at SMN When SMN prior to age at last menstrual period,
the age at event is the age of SMN with a
normal ovarian status.


Changed status (N = 102)

Table B.3: Summary of changed status
Original status New status N = 102 Reasons
Surgical PM SMN prior to surgical time.
Age at surgical time and age at the last were greater than 40, therefore she had normal ovarian status before 40 and was assigned to normal group.
Last menstrual period occurs much earlier than surgery and the time are within 5 years of cancer diagnosis.
Last menstrual period occurs much earlier than surgery at an age after 5 years of cancer diagnosis.
Normal NSPM occurs before surgical time.
Normal SMN happens prior to PM
NSPM age at last menstrual period When this age was greater than 40.
PM (possible) age at SMN When SMN prior to age at last menstrual period,
the age at event is the age of SMN with a
normal ovarian status.


Table B.4: Excluded subjects because of conflicting age information (N = 27 + 129)
Original status Reasons Numbers
Normal age at event < 9 years old 1
NSPM age at event < 9 years old 1
Surgical PM age at event < 9 years old 17
Surgical PM age at event occurred 3 years prior to age at diagnosis 3
AOF age at event occurred 3 years prior to age at diagnosis 5
Surgical PM age at surgical time were missing 129