期刊论文详细信息
BMC Public Health
Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement
Jean-Claude Pairon2  Bénédicte Clin1 
[1] Service de Santé au Travail et Pathologie Professionnelle (Occupational Health Department), C.H.U. (University Hospital) Côte de Nacre, 14033 CAEN Cedex, France;Centre Hospitalier Intercommunal de Créteil, Service de Pneumologie et de Pathologie Professionnelle, 94000 Créteil, France
关键词: Recommendations;    Medico-professional follow-up;    Occupational exposure;    Bladder cancer;   
Others  :  1123007
DOI  :  10.1186/1471-2458-14-1155
 received in 2014-02-01, accepted in 2014-10-17,  发布年份 2014
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【 摘 要 】

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.

【 授权许可】

   
2014 Clin et al.; licensee BioMed Central Ltd.

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