Case-Control Surveillance of Serious Illnesses and Drugs

The Case-Control Surveillance Study’s purpose is to systematically evaluate the relationship of medications to the incidence of certain illnesses and to screen for unsuspected drug/disease associations. Since 1983 the main focus of the study has been on various cancers. Patients from a network of hospitals in Philadelphia, who reside in specified ZIP Code areas and have a new (within 1 year) diagnosis of interest (e.g., breast cancer) are identified by nurse interviewers assigned to the hospitals and asked to participate. Non-cancer patients are similarly interviewed in order to amass a pool of potential controls. The latter are selected according to specific criteria: acute conditions (e.g. accidents, appendicitis), and other non-chronic diseases, or chronic conditions diagnosed within the past year (e.g. kidney stones, gallstones). Using a laptop computer, the nurse interviews the subject in their hospital room, after a consent has been signed. The data collected includes: demographic information, lifestyle habits (e.g. smoking, exercise, alcohol use), past and present illnesses, and a lifetime medication history elicited by asking for drug use for over 40 indications. In addition to the interview, since 1998 cheek cell samples are obtained by rubbing a soft brush on the inner cheek for about 15 seconds. This genetic component will investigate whether genetic polymorphisms modify associations of medications with disease. Discharge summaries and pathology reports are reviewed to verify diagnoses, and classify and stage all cancer diagnoses. To date, over 80,000 patients have been interviewed, including over 25,000 with incident cancer.