Rationale for an early detection program for bladder cancer

Abstract

Introduction:A total of 356,557 new cases were diagnosed annually worldwide in 2009, it was estimated that 52,810 new patients were to be diagnosed with bladder cancer and there were 10,180 projected deaths from the disease in the USA. Despite being the fourth commonest cancer in men, we do not have an early detection/screening program for bladder cancer. The review was aimed at looking at the evidence for the rationale for an early detection program for bladder cancer.Materials and Methods:A detailed search on bladder cancer epidemiology, diagnosis, pathology, tumor markers, treatment outcomes, screening, morbidity and mortality of bladder cancer was carried out on Pubmed central/Medline. Original articles, review articles, monograms, book chapters on bladder cancer, text books on urological oncology, oncology and urology were reviewed. The latest information for new articles before publication was last accessed in June 2010.Discussion and Conclusions:Bladder cancer is the fourth commonest cancer in men, the annual death rate from this disease is significant and every year there is an increase in its incidence globally. The prognosis of bladder cancer is stage and grade dependent; the lower the stage (T2 or less) the better is the survival. Delay in the diagnosis and treatment does alter the overall outcome. Therefore, there is a clear need for early detection of bladder cancer and screening program. Although we do not have an ideal marker for bladder cancer, it is time we maximize the potential of markers such as UroVysion, NMP22 along with cytology to start such a program. May be as a first step the early detection and screening program could be started in high-risk population. It is not worth waiting till we find the best marker as it would be unfair to our patients. The fear of unnecessary tests and treatment in bladder cancer after its detection in screening program is without any substance. The cost-effectiveness of such a program is certainly comparable to that is used for colon or breast and for prostate as well.

Pathological Characteristics of Primary Bladder Carcinoma Treated at a Tertiary Care Hospital and Changing Demographics of Bladder Cancer in Sri Lanka

“…The other tumours are squamous cell carcinoma, adenocarcinoma, and rare varieties like small cell carcinoma. Clinical stage and grade are the two most important determinants of the prognosis of bladder cancer [ 7 ]. Previous studies show varying results in relation to sex ratio, proportion of muscle invasive disease, and histological types of bladder cancer in Sri Lanka and in neighbouring South Asian countries [ 2 , 8 – 18 ].…”

Applications of Raman spectroscopy to the urinary bladder for cancer diagnostics

“…Examination of voided urine or bladder washing specimens for exfoliated cancer cells has high sensitivity in high-grade tumors but low sensitivity in low-grade tumors [2] . It has been shown that delays in the process of diagnosis leads to unsatisfactory outcomes and adverse effects for the patient involved [3,4] . Therefore, there is a real clinical need to develop and integrate a non-invasive, sensitive and specific technique to assist in bladder cancer diagnosis and differentiation between low-and high-grade diseases.…”

Elevated Phospholipase A2 Activities in Plasma Samples from Multiple Cancers

“…Pancreatic and bladder cancers count for (3–7% of all cancers), but pancreatic cancer (PC) is one of the deadest cancers, with a dismal 5-year survival rate of 6% [1]. The success of current cancer treatments depends strongly on the time of diagnosis, with early detection and identification of high risk patient populations resulting in the most favorable overall survivals in these diseases [1], [2]. It is expected that early detection and screening of high risk patient populations may have the most significant impact on altering overall survival in these diseases.…”