Form:	Lung Reference Clinical for Case Set C v1.1

CDE ID	CDE Description
* 1063	Site Participant ID (Go To: 422)
* 422	EDRN Site ID (Go To: 423)
* 423	EDRN Protocol ID (Go To: 1219)
* 1219	Date of contact (MM/DD/YYYY): (Go To: 2733)
* 2733	Proposed study group (Go To: 1216)
	Permissible Values (value): Set C Cases: Lung cancer (prospective) (21)
* 1216	Date of diagnosis of lung cancer (histological or cytopathological report) (MM/DD/YYYY): (Go To: 3174)
3174	Date (YYYY) of diagnosis of lung cancer (histological or cytopathological report) (Go To: 1302)
1302	Age at diagnosis (Go To: 1338)
1338	Histologic confirmation? (Go To: 1217)
	Permissible Values (value): No (0)
	Yes (1)
1217	Date of thoracotomy (MM/DD/YYYY): (Go To: 1268)
1268	PET scan date (MM/YYYY): (Go To: 1269)
1269	PET scan standardized uptake value (SUV) for the lesion: (Go To: 1273)
	Permissible Values (value): Less than 2.5 (1)
	Greater than or equal to 2.5 (2)
1273	PET scan standardized uptake value (SUV) for the liver: (Go To: 1274)
1274	PET scan other hotspots: (Go To: 786)
	Permissible Values (value): Mediastinum (1)
	Bone (2)
	Brain (3)
	Adrenal (5)
	Liver (10)
	Lung (12)
	None (44)
786	Lung T-Stage, Pathologic (Go To: 789)
	Permissible Values (value): pTX (1)
	pT0 (2)
	pTis (4)
	pT1 (8)
	pT2 (13)
	pT3 (16)
	pT4 (19)
789	Lung N-Stage, Pathologic (Go To: 790)
	Permissible Values (value): pNX (1)
	pN0 (2)
	pN1 (7)
	pN2 (12)
	pN3 (15)
790	Lung M-Stage, Pathologic (Go To: 785)
	Permissible Values (value): pMX (1)
	pM0 (2)
	pM1 (3)
785	Lung T-Stage, Clinical (Go To: 787)
	Permissible Values (value): TX (1)
	T0 (2)
	Tis (3)
	T1 (4)
	T2 (5)
	T3 (6)
	T4 (7)
787	Lung N-Stage, Clinical (Go To: 788)
	Permissible Values (value): NX (1)
	N0 (2)
	N1 (3)
	N2 (4)
	N3 (5)
788	Lung M-Stage, Clinical (Go To: 1240)
	Permissible Values (value): MX (1)
	M0 (2)
	M1 (3)
1240	Reported adenopathy > 1 cm in the mediastinum at time of diagnosis? (Go To: 1266)
	Permissible Values (value): No (0)
	Yes (1)
	Unknown/refused (9)
1266	Other lung diseases participant has: (Go To: 1249)
	Permissible Values (value): COPD (1)
	Asthma (2)
	Pulmonary fibrosis (3)
	Sarcoidosis (4)
	Granulomatosis (5)
	Cavitary lesion (6)
	Bronchiectasis (7)
1249	Pulmonary function test date (MM/DD/YYYY): (Go To: 1250)
1250	FVC liters (Go To: 1251)
1251	FVC % predicted: (Go To: 1252)
1252	FEV1 liters: (Go To: 1253)
1253	FEV1 % predicted: (Go To: 1254)
1254	FEV1/FVC (Go To: 1255)
1255	DLCO liters/minute/mmhg (Go To: 1256)
1256	DLCO % predicted: (Go To: 1292)
1292	Height [in inches] (What is your total current height in inches?) (Go To: 1295)
1295	Weight [in pounds] (What is your current weight [in pounds]? (Go To: 2148)
2148	Primary cancer treatment(s) received: (Go To: 1258)
	Permissible Values (value): Chemotherapy (1)
	Radiation therapy (2)
	Surgery (3)
	Hormone therapy (4)
	Cryotherapy (5)
	Unknown/refused (9)
	None (44)
	Other (95)
1258	Chemotherapy treatment(s) received: [specify drug(s)] (Go To: 1259)
1259	Chemotherapy start date (MM/YYYY): (Go To: 1260)
1260	Chemotherapy end date (MM/YYYY): (Go To: 1261)
1261	Radiation therapy received: (specify site) (Go To: 1262)
1262	Radiation therapy start date: (MM/YYYY): (Go To: 1263)
1263	Radiation therapy end date: (MM/YYYY): (Go To: 1264)
1264	Total dose to chest: (cGy) (Go To: 1265)
1265	Total dose to other organ(s): (cGy) (Go To: 1282)
1282	Radiation therapy (RT) volume [cubic mm]: (Go To: 1281)
1281	Radiation therapy (RT) complications: (Go To: 1279)
	Permissible Values (value): Pneumonitis requiring steroids (1)
	Esophagitis requiring IVF (2)
	Feeding tube (3)
	Hospitalization (4)
	Other (95)
1279	Response to treatment (imaging criteria) (Go To: 1278)
	Permissible Values (value): No (0)
	Yes (1)
1278	Date of response (MM/DD/YYYY): (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)