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- More knowledge is needed about factors that can help identify patients who are at greater risk of disease recurrence and progression to minimize the need for screening and to help guide treatment.
- The New England Study of Environment and Health (NESEH), conducted by the departments of health in Maine, New Hampshire and Vermont, the Dartmouth Medical School and the NIH, examined the relationship between health and environmental factors such as smoking, diet and water quality in New England. This study provides an opportunity to learn more about patients with bladder cancer.
- Before launching a full-scale follow-up study on bladder cancer, it is necessary to determine the feasibility of obtaining needed follow-up information from patients enrolled in the NESEH.
-To determine the completeness and quality of information about treatment, recurrence, and progression that can be obtained for patients from their medical records.
-Participants from the NESEH study who are residents of Maine and who were diagnosed with bladder cancer between 2001 and 2003.
- Determine the vital status of NESEH bladder cancer patients.
- Select a sample of 40 living and 18 deceased patients.
- Interview patients or their next of kin by telephone for about 30 to 45 minutes to update exposure information, obtain names and addresses of all hospitals and physicians they have seen since diagnosis, and obtain authorization to access medical records.
- Obtain and abstract medical records.
- 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 more aggressively.
- 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
National Cancer Institute (NCI), 9000 Rockville Pike
National Institutes of Health Clinical Center (CC)
Published on BioPortfolio: 2015-04-30T15:53:24-0400
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Tumors or cancer of the URINARY BLADDER.
A HERNIA-like condition in which the weakened pelvic muscles cause the URINARY BLADDER to drop from its normal position. Fallen urinary bladder is more common in females with the bladder dropping into the VAGINA and less common in males with the bladder dropping into the SCROTUM.
Involuntary discharge of URINE as a result of physical activities that increase abdominal pressure on the URINARY BLADDER without detrusor contraction or overdistended bladder. The subtypes are classified by the degree of leakage, descent and opening of the bladder neck and URETHRA without bladder contraction, and sphincter deficiency.
An abnormal passage in the URINARY BLADDER or between the bladder and any surrounding organ.
Blocked urine flow through the bladder neck, the narrow internal urethral opening at the base of the URINARY BLADDER. Narrowing or strictures of the URETHRA can be congenital or acquired. It is often observed in males with enlarged PROSTATE glands.
Non-invasive bladder cancer is a cancer that is only in the inner lining of the bladder. Invasive bladder cancer is cancer that has spread into the deeper walls of the bladder. When the cancer has spread outside the bladder to other parts of the body, th...