[Validation of a screening method for occupational bladder cancer].
BACKGROUND
Transitional bladder cancer is the most frequent malignant urinary neoplasm. Occupational exposure to aromatic amines and to polycyclic aromatic hydrocarbons are the main risk factors, in addition to cigarette smoking, recurrent inflammatory diseases of the urinary tract, consumption of certain drugs and a positive family history. Nevertheless cases of work-related bladder cancer are poorly identified in Italy.


OBJECTIVE
The aim of this study is to assess the screening accuracy of a short structured interview to detect suspected cases of occupational bladder cancer, which may be confirmed in a second step assessment by an occupational physician.


METHODS
The study sample consisted of 94 transitional bladder cancer patients, first hospitalised in 2004 and 2005 at the Department of Urology of the Ospedale di Circolo - Fondazione Macchi, in Varese, Italy. Based on data collected through a simple structured interview, it was possible to estimate two occupational exposure indices: one taking into account only the length of employment in industrial settings (DS Index) and the other considering job title in addition (DSM Index). For all cases a second-step assessment by an occupational physician (gold standard) made it possible to establish the occupational origin of cancer and to assess accuracy.


RESULTS
Satisfactory values of the area under the ROC curve were found for both indices (AUC 0,81 for DS and 0,87 for DSM). In particular at the same level of sensitivity (90%), the DSM Index showed a better specificity (72%) in comparison to the DS Index (64%).


CONCLUSIONS
The short structured interview proposed here proved to be a valuable tool for general practitioners and urologists to detect cases of bladder cancer of suspected occupational aetiology, which can be referred to an occupational physician for further investigations.
Borchini
Rossana
R
Medicina del Lavoro e Preventiva, Ospedale di Circolo, Fondazione Macchi, Varese.
Bonzini
M
M
Veronesi
G
G
Fava
C
C
Carenzi
Maria Chiara
MC
Mombelli
Silvia
S
Marconi
A
A
Bono
A V
AV
Ferrario
M M
MM
D000368:Aged; D019540:Area Under Curve; D002274:Carcinogens, Environmental; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000209:etiology; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology; D016273:Occupational Exposure; D009790:Occupations; D012372:ROC Curve; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000209:etiology
D002274:Carcinogens, Environmental