Feasibility Study: Follow-Up of Bladder Cancer Patients From the New England Study of Environment and Health
- Bladder cancer is a highly recurrent disease with substantial variability in survival.
- Patients currently undergo repeated cystoscopy for many years after diagnosis.
- There is a need to identify prognostic markers of recurrence and progression to
minimize the need for routine screening and to identify patients who should be treated
- The New England Study of Environment and Health (NESEH), a population-based case
control study of 1,213 patients in Maine (ME), Vermont (VT), and New Hampshire (NH),
provides an excellent opportunity study the clinical, host-genetic, and environmental
determinants of prognosis.
- Before launching a full-scale follow-up study, we need to determine the feasibility of
following a population-based case series and of obtaining patient-related (vital
status, exposures) and tumor-related (recurrence, progression, pathology) information.
- The completeness and quality of information that can be obtained for each patient. The
most important issue is the extent to which medical records from private physicians
will be needed, and whether private physicians are cooperative.
- Our ability to identify next-of-kin (NOK) of deceased patients.
- The proportion of patients (and NOK) that we can contact and enroll.
- The ability of NOK to provide information on exposures.
-Bladder cancer patients from ME who participated in the original case-control study (ages
30-79, newly diagnosed with histologically-confirmed carcinoma of the bladder, including
carcinoma in situ), excluding those diagnosed after 2003 (5 years of follow-up are needed).
- Conduct interviews with 40 living patients and the NOK of 9 deceased patients to update
exposure information and find out where the patient received health care, the types of
treatment received, and whether and when the disease recurred or progressed.
- For living patients or NOK that we are unable to locate (an estimated 10 living
patients and 9 NOK), request medical records from health care providers (to see if
physicians will provide records in the absence of an authorization form).
- Evaluate participant and physician response rates and the completeness of the medical
history information obtained.
- We will proceed with the full study if we obtain sufficient medical information for 70%
of the living patients.
- We will examine whether there were important issues related to deceased patients (e.g.,
NOK identification/enrollment, exposure assessment, access to medical records). If so,
consider a simpler approach for this segment of the population (e.g., survival study
based on NDI Plus and information available from the NESEH).
Time Perspective: Retrospective
Joanne S Colt
National Cancer Institute (NCI)
United States: Federal Government
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