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Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement
BACKGROUND: The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to carcinogenic substances for the bladder. METHODS: A critical synthesis of the literature was conducted. Sectors of activity where workers are or were exposed to c...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230399/ https://www.ncbi.nlm.nih.gov/pubmed/25377503 http://dx.doi.org/10.1186/1471-2458-14-1155 |
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author | Clin, Bénédicte Pairon, Jean-Claude |
author_facet | Clin, Bénédicte Pairon, Jean-Claude |
author_sort | Clin, Bénédicte |
collection | PubMed |
description | BACKGROUND: The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to carcinogenic substances for the bladder. METHODS: A critical synthesis of the literature was conducted. Sectors of activity where workers are or were exposed to carcinogenic substances for the bladder were listed and classified according to the level of bladder cancer risk. Performances of techniques available for the targeted screening of bladder cancer were analysed, including a simulation of results among high-risk populations in France. RESULTS: The risk level for the professional group and the latency period between the start of exposure and the natural history of the disease were selected to define a targeted screening protocol. The NMP22BC test, exclusive haematuria testing, and combinations of urine cytology with, respectively, the NMP22BC test and haematuria test, generated an extremely high proportion of false positive results. CONCLUSION: Urine cytology is the test that offers the best specificity. Although poor for all bladder cancer stages and grades combined, its sensitivity is better for high grades, which require early diagnosis since late-stage cancers are of very poor prognosis. These results suggest that urine cytology is currently the only technique suitable for proposal within the context of a first line targeted screening strategy for occupational bladder cancer. An algorithm summarising the recommended medical follow-up for workers currently or previously exposed to carcinogenic substances for the bladder is proposed, based on the level of risk of bladder cancer. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2458-14-1155) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4230399 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42303992014-11-14 Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement Clin, Bénédicte Pairon, Jean-Claude BMC Public Health Research Article BACKGROUND: The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to carcinogenic substances for the bladder. METHODS: A critical synthesis of the literature was conducted. Sectors of activity where workers are or were exposed to carcinogenic substances for the bladder were listed and classified according to the level of bladder cancer risk. Performances of techniques available for the targeted screening of bladder cancer were analysed, including a simulation of results among high-risk populations in France. RESULTS: The risk level for the professional group and the latency period between the start of exposure and the natural history of the disease were selected to define a targeted screening protocol. The NMP22BC test, exclusive haematuria testing, and combinations of urine cytology with, respectively, the NMP22BC test and haematuria test, generated an extremely high proportion of false positive results. CONCLUSION: Urine cytology is the test that offers the best specificity. Although poor for all bladder cancer stages and grades combined, its sensitivity is better for high grades, which require early diagnosis since late-stage cancers are of very poor prognosis. These results suggest that urine cytology is currently the only technique suitable for proposal within the context of a first line targeted screening strategy for occupational bladder cancer. An algorithm summarising the recommended medical follow-up for workers currently or previously exposed to carcinogenic substances for the bladder is proposed, based on the level of risk of bladder cancer. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2458-14-1155) contains supplementary material, which is available to authorized users. BioMed Central 2014-11-06 /pmc/articles/PMC4230399/ /pubmed/25377503 http://dx.doi.org/10.1186/1471-2458-14-1155 Text en © Clin et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Clin, Bénédicte Pairon, Jean-Claude Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement |
title | Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement |
title_full | Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement |
title_fullStr | Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement |
title_full_unstemmed | Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement |
title_short | Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement |
title_sort | medical follow-up for workers exposed to bladder carcinogens: the french evidence-based and pragmatic statement |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230399/ https://www.ncbi.nlm.nih.gov/pubmed/25377503 http://dx.doi.org/10.1186/1471-2458-14-1155 |
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