Bladder cancer screening at the Dupont Chambers Works: a new initiative.

Persons occupationally exposed to known or suspected human bladder carcinogens are being recruited for a 3-year case-control study of the efficacy of and adherence to a home self-testing protocol for microscopic hematuria as a method for early detection of treatable urologic conditions, including bladder cancer. All employees of the DuPont Chambers Works who are currently in the tumor surveillance program (those known to have been exposed to beta-naphthylamine, benzidine, and 4,4'-methylenebis(2-chloroaniline] will be asked to participate. Age-matched controls will be recruited from the community. Recent advances in identifying clinical signs of underlying bladder disease among the asymptomatic have been implemented in our screening design. Quarterly urinalyses will include the traditional microscopic examination of the urine to detect red blood cells. Participants will test their urine for microhematuria using the Ames HemastixR for 14 consecutive days every other quarter. On alternating quarters, cytologies will be performed. Persons who test positive (hematuria and/or abnormal cytology) will be referred for a complete urologic workup.