Form:	Lung Reference Clinical for Case Set B Follow-up v1.0

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: 1292)
	Permissible Values (value): Set B Cases: Lung cancer (CT screening) (6)
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: 1272)
1272	Living status: (Go To: 1218)
	Permissible Values (value): Alive with disease (1)
	Alive with no evidence of disease (NED) (2)
	Dead (3)
	Unknown (99)
1218	Last date known alive (MM/DD/YYYY): (Go To: 1336)
1336	Date of death (MM/DD/YYYY): (Go To: 1332)
1332	Cause of death: (Go To: 1271)
1271	Comorbidities: (Go To: 1220)
	Permissible Values (value): Myocardial infarction (1)
	Congestive heart failure (2)
	Peripheral vascular disease (3)
	Cerebrovascular disease (4)
	Dementia (5)
	Chronic pulmonary disease (6)
	Connective tissue disease (7)
	Ulcer disease (8)
	Mild liver disease (9)
	Diabetes (10)
	Hemiplegia (11)
	Moderate or severe renal disease (12)
	Diabetes with end organ damage (13)
	Moderate or severe liver disease (14)
	Metastatic solid tumor (15)
	AIDS (16)
1220	Disease status: (Go To: 1276)
	Permissible Values (value): Relapsed (1)
	Refractory (2)
	Stable Disease (3)
	Progression (4)
	Recurrence/relapse (5)
	Primary (advanced) (6)
	No evidence of disease (7)
	Unknown/refused (9)
1276	Disease free survival (DFS)? (Go To: 1280)
	Permissible Values (value): No (0)
	Yes (1)
1280	Overall survival (OS) in days: (Go To: 1221)
1221	Recurrence date (MM/YYYY): (Go To: 1222)
1222	Recurrence site: (Go To: 1277)
	Permissible Values (value): Bladder (1)
	Bone (2)
	Brain (3)
	Breast (4)
	Cervix (5)
	Colon (6)
	Esophagus (7)
	Head & neck (mouth, nose, and throat) (8)
	Kidney (9)
	Liver (10)
	Leukemia (11)
	Lung (12)
	Lymphoma, including Hodgkins (13)
	Ovary (14)
	Pancreas (15)
	Prostate (16)
	Rectum (17)
	Skin (melanoma, no basal or squamous) (18)
	Stomach (19)
	Thyroid (20)
	Uterus (21)
	Testis (24)
	Vagina (26)
	None (44)
	Other (95)
	Unknown/refused (99)
1277	Time to local recurrence (TTLR): (Go To: 1223)
1223	Progression date (MM/YYYY): (Go To: 1224)
1224	Progression site: (Go To: 1275)
	Permissible Values (value): Bladder (1)
	Bone (2)
	Brain (3)
	Breast (4)
	Cervix (5)
	Colon (6)
	Esophagus (7)
	Head & neck (mouth, nose, and throat) (8)
	Kidney (9)
	Liver (10)
	Leukemia (11)
	Lung (12)
	Lymphoma, including Hodgkins (13)
	Ovary (14)
	Pancreas (15)
	Prostate (16)
	Rectum (17)
	Skin (melanoma, no basal or squamous) (18)
	Stomach (19)
	Thyroid (20)
	Uterus (21)
	Testis (24)
	Vagina (26)
	None (44)
	Other (95)
	Unknown/refused (99)
1275	Time to progression in days (TTP): (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)