Screening for Bladder Cancer: Reliability and Limitations

Narter K. F. , Sahin C.

UROONKOLOJI BULTENI-BULLETIN OF UROONCOLOGY, vol.14, no.1, pp.38-45, 2015 (Journal Indexed in ESCI) identifier

  • Publication Type: Article / Review
  • Volume: 14 Issue: 1
  • Publication Date: 2015
  • Doi Number: 10.4274/uob.238
  • Page Numbers: pp.38-45


Bladder cancer is the fourth most common cancer in men and the ninth in women, frequency of the disease increases with age. Bladder cancer accounts for 7% of the newly diagnosed cancer cases among men and for 3% of the deaths due to cancer in USA in 2012. Survival from the disease has not improved in the last 25 years. Bladder cancer is one of the most costly cancers. About 25% of tumors are muscle invasive or metastatic at diagnosis. The aim of the screening is to detect the disease at the early stage. Cystoscopy is the gold standard for diagnosis, but since it is an invasive method for population based screenings and not cost effective, it is not applicable. In order to decrease unnecessary cystoscopies, researchers should try urine stripe test for hematuria and other cost effective and high performance molecular markers in the sequential screening approach, especially in populations at high risk. Diagnostic performance of the urine markers as screening test is inadequate for today and there is no efficient screening test protocol. In a few case control series, screening tests were shown to may have positive effects on survival duration. Tumors that can be detected on screening tests are usually low graded tumors and may be easily overlooked. Although bladder cancer screening may be appropriate for populations at high risk, evidence level is inadequate. The problem is that appropriate population could not be determined for screening, that a clear screening protocol could not be established due to lack of appropriate and cost effective urine markers in the detection of bladder cancers. There is need more efficient new researches about this topic.