Bladder Cancer Clinical Trial
Official title:
Feasibility Study: Follow-Up of Bladder Cancer Patients From the New England Study of Environment and Health
Background:
- Bladder cancer often recurs after treatment and patient survival varies greatly.
- 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.
Objectives:
-To determine the completeness and quality of information about treatment, recurrence, and
progression that can be obtained for patients from their medical records.
Eligibility:
-Participants from the NESEH study who are residents of Maine and who were diagnosed with
bladder cancer between 2001 and 2003.
Design:
- 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.
Background:
- 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.
Objectives:
To determine:
- 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.
Eligibility:
-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).
Design:
- 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).
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