Bladder Cancer Detection and Monitoring: Assessment of Urine- and Blood-Based Marker Tests

Goodison, Steve; Rosser, Charles J.; Urquidi, Virginia

doi:10.1007/s40291-013-0023-x

Cited by 114 publications

(90 citation statements)

References 148 publications

(152 reference statements)

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“…Although cystoscopy can identify nearly all papillary and sessile lesions [59], it is an invasive and unpleasant procedure for patients and not suitable for the routine monitoring necessitated by bladder cancer [60,61]. A non-invasive assay would provide significant benefits for patient comfort, with urine as an ideal sample for bladder cancer diagnosis and follow-ups due to the ease of obtaining patient samples in a non-invasive manner [9]. Based on established guidelines, it is currently not recommended to test urinary biomarkers in place of cystoscopy [16,17,62].…”

Section: Invasive Techniquesmentioning

confidence: 99%

Microdevices for Non-Invasive Detection of Bladder Cancer

et al. 2017

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Bladder cancer holds the record for the highest lifetime cost on a per-patient basis. This is due to high recurrence rates, which necessitate invasive and costly long-term evaluation methods such as cystoscopy and imaging. Microfluidics is emerging as an important approach to contribute to initial diagnosis and follow-up, by enabling the precise manipulation of biological samples. Specifically, microdevices have been used for the isolation of cells or genetic material from blood samples, sparking significant interest as a versatile platform for non-invasive bladder cancer detection with voided urine. In this review, we revisit the methods of bladder cancer detection and describe various types of markers currently used for evaluation. We detail cutting-edge technologies and evaluate their merits in the detection, screening, and diagnosis of bladder cancer. Advantages of microscale devices over standard methods of detection, as well as their limitations, are provided. We conclude with a discussion of criteria for guiding microdevice development that could deepen our understanding of prognoses at the level of individual patients and the underlying biology of bladder cancer development. Collectively, the development and widespread application of improved microfluidic devices for bladder cancer could drive treatment breakthroughs and establish widespread, tangible outcomes on patients' long-term survival.

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Section: Invasive Techniquesmentioning

confidence: 99%

Microdevices for Non-Invasive Detection of Bladder Cancer

et al. 2017

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“…6 Over the past several decades, a number of urinary biomarkers have been developed and commercialized to aid in the follow up of patients with NMIBC. 7 These tests can supplement surveillance cystoscopies by improving their diagnostic yield 8 and could potentially reduce the reliance on cystoscopies in the follow up of such patients by replacing them partially or completely, leading to decreased patient morbidity and costs. 9 However, the diagnostic accuracy of such tests is still far from perfect, and any benefits obtained by forgoing cystoscopy in favor of such tests must be balanced against their reduced sensitivity and specificity.…”

Section: Introductionmentioning

confidence: 99%

“…9 However, the diagnostic accuracy of such tests is still far from perfect, and any benefits obtained by forgoing cystoscopy in favor of such tests must be balanced against their reduced sensitivity and specificity. 7 Thus, the choice of whether to reduce the number of surveillance cystoscopies in favor of these biomarkers remains challenging. In an attempt to address this issue, we decided to perform a questionnaire-based study that aims to gauge what diagnostic accuracy and cost would a urinary biomarker(s) need to attain in order for both NMIBC patients and their treating urologic oncologists to comfortably forgo surveillance cystoscopy in favor of these non-invasive tests.…”

Section: Introductionmentioning

confidence: 99%

Replacing surveillance cystoscopy with urinary biomarkers in followup of patients with non-muscle-invasive bladder cancer: Patients’ and urologic oncologists’ perspectives

Sayyid¹,

Sayyid²,

Klaassen³

et al. 2018

CUAJ

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Introduction: Urinary biomarkers are being developed to detect bladder cancer recurrence/progression in patients with non-muscle invasive bladder cancer (NMIBC). We conducted a questionnaire-based study to determine what diagnostic accuracy and cost would such test(s) need for both patients and urologic oncologists to comfortably forgo surveillance cystoscopy in favor of these tests. Methods: Surveys were administered to NMIBC patients at followup cystoscopy visit and to physician members of the Society of Urologic Oncology. Participants were questioned about acceptable false-negative (FN) rates and costs for such alternatives, in addition to demographics that could influence chosen error rates and costs. Results: A total of 137 patient and 51 urologic oncologist responses were obtained. Seventy-seven percent were not comfortable with urinary biomarker(s) alternatives to repeat cystoscopy, with a further 14% willing to accept such alternatives only if the FN rate were 0.5% or lower. Seventy-five percent of urologic oncologists were comfortable with an alternative urinary biomarker test(s), with 37% and 33% willing to accept FN rates of 5% and 1%, respectively. Forty-seven percent of patients were not willing to pay out-of-pocket for such tests, while 61% of urologic oncologists felt that a price range of $100-500 would be reasonable. Conclusions: This is the first survey evaluating patient and urologic oncologist perspectives on acceptable error rates and costs for urinary biomarker alternatives to surveillance cystoscopy for patients with NMIBC. Despite potential responder bias, this study suggests that urinary biomarker(s) will require sensitivity equivalent to that of cystoscopy in order to completely replace it in surveillance of patients with NMIBC.

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“…Urine cytology is poorly differentiated tumors and time-consuming practice for both the patient and physician [6,7]. The diagnosis and monitoring of bladder cancer are facilitated by the availability of newer, simpler urine based diagnostic tests [2,8,9]. Recently, a number of molecular markers, such as BLCA-4, NMP52 and chromosomal aberrations, have been studied extensively by various groups [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%