Information Collection Request

Prostate, Lung, Colorectal and Overian Cancer Screening Trial (PLCO) (NCI)

ICR 201107-0925-004 · OMB 0925-0407 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Annual Study Update (ASU) for PLCO Form and Instruction Modified Available
Form 4 Script for Non-responders to ASU Form and Instruction New Available
Form 3 Supplemental Questionnaire (SQX) for PLCO Form New Available
Form 4 Prostate Cancer Recurrence Questionnaire (PCRQ) for PLCO Form Removed Repair queued
Form 2a Health Status Questionnaire (HSQ) for PLCO Form Modified Available
Supporting Statement B_PLCO_7-8-2011.docx Supporting Statement B Uploaded 2011-07-08 Available
Attach_15_PIA.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_13_Sampling & Power.pdf Supplementary Document Uploaded 2011-07-08 Available
Attach_12_Cover Letters.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_11_PLCO Publications_2011.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_10_Memo from NIH Privacy Act Officer.pdf Supplementary Document Uploaded 2011-07-08 Available
Attach_08_Confidentiality Procedures.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_07_Consent & Authorization.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_09_Assurances of Compliance.pdf Supplementary Document Uploaded 2011-07-08 Available
Attach_06_Steering Committee and DSMD.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_02_Users of Scientific Findings.doc Supplementary Document Uploaded 2011-07-08 Available
Attach_01_Literature Review.pdf Supplementary Document Uploaded 2011-07-08 Available
Cover Memo_PLCO.doc Supplementary Document Uploaded 2011-07-08 Available
Supporting Statement A_PLCO_7-11-2011.docx Supporting Statement A Uploaded 2011-07-11 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7306 Annual Study Update (ASU) for PLCO Form and Instruction Modified
198526 Script for Non-responders to ASU Form and Instruction New
198525 Supplemental Questionnaire (SQX) for PLCO Form New
186213 Prostate Cancer Recurrence Questionnaire (PCRQ) for PLCO Form Removed
186212 Health Status Questionnaire (HSQ) for PLCO Form Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2014 36 Months From Approved 10/31/2011
191,600 0 135,741
54,693 0 11,401
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 191,600 135,741 0 55,859 0 0
Annual Time Burden (Hours) 54,693 11,401 0 43,292 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No