Becaplermin Use and Cancer Risk in a Patient Population of U.S. Veterans With Diabetes

• The number and rate of cases of incident cancers (grouped as non melanoma skin cancer, all other invasive cancers combined, and site specific cancers) in patients who have used becaplermin and patients who have not used becaplermin. [ Time Frame: From time of recruitment beginning in October 1, 1999 until the earliest of September 30, 2007, outcome identification, or death. ] [ Designated as safety issue: Yes ]
  
• The number and rate of deaths from cancer in patients who have used becaplermin and patients who have not used not used becaplermin. [ Time Frame: From time of accrual beginning in October 1, 1999 until the earliest of September 30, 2007 or death. ] [ Designated as safety issue: Yes ]
  

• The number of becaplermin doses associated with risk of incident cancer and/or cancer death. [ Time Frame: From the date of the first becaplermin dispensing beginning October 1, 1999 until the earliest of September 30, 2007, outcome identification, or death. ] [ Designated as safety issue: Yes ]
  

This is an observational study of patients with diabetes who are eligible for care through the national Department of Veterans Affairs Health Care System (VA), representing the largest sample of older adults in an integrated health care system in the U.S. with comprehensive electronic medical records and linkable health survey data. REGRANEX (becaplermin) is topical medication used to treat lower extremity diabetic neuropathic ulcers. VA patients with diabetic foot ulcers who have no prior history of cancer who have received treatment with becaplermin will be compared to a group of similar patients who have not received treatment with becaplermin. Becaplermin users (from the time of initial dispensing of becaplermin) and becaplermin nonusers will be followed forward in time for up to 8 years to identify new cancers and cancer related deaths, with confirmation of cases through registries and medical chart review. This is an observational study; no investigational drug will be administered.