Bladder cancer screening at the DuPont Chambers Works: a new initiative

Article Abstract:

In May 1989, the Dupont Chambers Works entered into a collaborative agreement with the Fox Chase Cancer Center to develop, implement and evaluate a screening protocol for treating urologic conditions, including bladder cancer. Employees exposed to bladder carcinogens, 4,4'-methylene(2-chloroaniline) (MBOCA), beta-naphthylamine, and benzidine, and potentially-exposed local residents were invited to participate in the program. Using urinary dipsticks in a home screening study, microhematuria was reported with 99 percent specificity, 91 percent sensitivity and 96 percent efficiency, relative to microscopic evaluation. Among participants of the cytology screening program, hematuria was shown to occur twice as frequently in those who later developed bladder cancer than in those who did not. The screening protocol for the new program used hematuria as the decision point. The aims of the ongoing project are to assess the efficacy of a home screening hematuria program, and to develop, for those at high risk for bladder cancer, appropriate interventions, including self-testing systems. The tests are being conducted with Ames Hemastix. Participants include men from the cytology program, and potentially-exposed retirees, yielding a total of 850 exposed men; 600 men served as matched-controls. After enrollment, cases and controls were given instructions, and home test kits, with materials for 14 days. The first test was conducted at the clinic and duplicated by professional staff, permitting monitoring of how the participants conducted and evaluated the test. Those with positive hematuria will be further evaluated by a physician. Urinalysis, culture, an autocrine motility factor determination (AMF), cytology, and a quantitative fluorescence image analysis (QFIA) will be performed. Further follow-up, as indicated, will be conducted and include extensive physical examination, intravenous pyelograms and cystoscopy. This study of occupationally exposed workers is the first cancer control research program to study the specificity, sensitivity and predictive value of a test for microhematuria and to correlate its results with other clinical and laboratory findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Product/Service Evaluation, Demographic aspects, Medical test kits, E.I. du Pont de Nemours and Co. Chambers Work Div., Ames Hemastix (Medical test kit)

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Bladder cancer screening among primary aluminum production workers in Quebec

Article Abstract:

An excessive incidence of bladder cancer had been reported among workers in primary aluminum production plants using the Soderberg process, which involves exposure to coal-tar-pitch volatiles (CTV). The exposure to these chemicals has shown a dose-response relationship with risk for bladder cancer. Cancer in primary aluminum production workers was recognized as an industrial disease, and as a result, one producer initiated routine annual cytology screening. From January 1970 through June 1986, 79 cases of bladder cancer were identified among these employees, aged 65 years and younger. By the end of 1986, 36 workers died, with bladder cancer as the cause of death in 19 cases. A comparison between the cases uncovered after the introduction of the company screening program in 1980 with those diagnosed earlier did not reveal statistically significant increased survival or early diagnosis. These findings do not encourage a point of view that would adopt routine screening. However, the authors specify that the earlier data were recovered from records in the public domain, which by their nature, may have been insufficient to provide a basis from which to draw valid conclusions. Screening should not be ruled out until further studies are made to determine its value for occupationally-related bladder cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Aluminum plants

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