The Sister Study: Environmental and Generic Risk Factors for Breast Cancer

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 SIS_Annual_Forms_20121018_Att 1A	Form and Instruction	Modified	Available
Form 1 SIS_OMB_2012_WebScreenShots_20121024 Att 12	Form and Instruction	Modified	Available
Form 2 survey	Form and Instruction	Removed	Available
Form 1 survey	Form and Instruction	Removed	Repair queued
Form 2 survey	Form and Instruction	Removed	Available
Form 1 survey	Form and Instruction	Removed	Available
Form 2 survey	Form and Instruction	Removed	Available
Form 1 survey	Form and Instruction	Removed	Available
Form 1 SIS_Biennial_Triennial_FollowupScripts_20121018_Att 2C	Form and Instruction	Modified	Available
Form 1 SIS_Triennial_Forms_20121018_Att 2A	Form and Instruction	Modified	Available
SISOMB2012suppstmtBver1final.doc	Supporting Statement B	Uploaded 2012-10-26	Available
SISOMB2012att3consults.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att4StaffConf.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att5CofC.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att6irbinit.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att7CGIRBinit.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att8IRBCR.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SIS_CGIRB_CR_Approval_20120927_Att9.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att10consent.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012att11stress.pdf	Supplementary Document	Uploaded 2012-10-26	Available
SISOMB2012suppstmtAver1_1final10-24.doc	Supporting Statement A	Uploaded 2012-10-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43630	Annual Updates	Form and Instruction	Modified	SIS_Annual_Forms_20121018_Att 1A
43630	Annual Updates	Form and Instruction	Modified	SIS_OMB_2012_WebScreenShots_20121024 Att 12
190836	Incident Case Medical Office Contact	Form and Instruction	Removed	survey
190836	Incident Case Medical Office Contact	Form and Instruction	Removed	survey
190835	Incident Other Case Follow-Up	Form and Instruction	Removed	survey
190835	Incident Other Case Follow-Up	Form and Instruction	Removed	survey
190834	Incident BC Case Follow-Up	Form and Instruction	Removed	survey
190834	Incident BC Case Follow-Up	Form and Instruction	Removed	survey
190833	Bi/Trienniel Follow-Up	Form and Instruction	Modified	SIS_Biennial_Triennial_FollowupScripts_20121018_Att 2C
190833	Bi/Trienniel Follow-Up	Form and Instruction	Modified	SIS_Triennial_Forms_20121018_Att 2A

ICR Details

OMB Control No: 0925-0522	ICR Reference No: 201211-0925-004
Status: Historical Active	Previous ICR Reference No: 200909-0925-005
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: The Sister Study: Environmental and Generic Risk Factors for Breast Cancer
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/04/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/09/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2016	36 Months From Approved	02/28/2013
Responses	50,884	0	154,200
Time Burden (Hours)	26,855	0	72,218
Cost Burden (Dollars)	0	0	0

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Abstract: The NIEHS Sister Study is a prospective epidemiological study to examine environmental and familial risk factors for breast cancer and other diseases in a high-risk cohort of 50,000 sisters of women who have had breast cancer.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 48993	08/15/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 66851	11/07/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Annual Updates	1, 1	SIS_OMB_2012_WebScreenShots_20121024 Att 12 ,   SIS_Annual_Forms_20121018_Att 1A
Bi/Trienniel Follow-Up	1, 1	SIS_Triennial_Forms_20121018_Att 2A ,   SIS_Biennial_Triennial_FollowupScripts_20121018_Att 2C
Incident BC Case Follow-Up	1, 2	survey ,   survey
Incident Case Medical Office Contact	1, 2	survey ,   survey
Incident Other Case Follow-Up	1, 2	survey ,   survey

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ICR Summary of Burden

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	50,884	154,200	0	0	-103,316	0
Annual Time Burden (Hours)	26,855	72,218	0	0	-45,363	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $5,682,612

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/09/2012

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