Systematic review of the clinical effectiveness and cost-effectiveness of photodynamic diagnosis and urine biomarkers (FISH, ImmunoCyt, NMP22) and cytology for the detection and follow-up of bladder cancer

Abstract

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Clinical features of bladder cancer in primary care

“…12 Several other features of bladder cancer have been described in the secondary care literature, including lower urinary tract symptoms, abdominal pain, and masses. 2,13 The aim of this study was to identify the symptoms of bladder cancer in primary care, and to quantify them, both singly and in pairs. This should allow improved selection of patients for investigation, reducing the human and economic cost of this disease.…”

“…1 It is strongly associated with cigarette smoking, and is approximately 2.5 times more common in males. 2 The incidence rises with age, with the average age at diagnosis being 71 years. 2 At the time of diagnosis in the UK, approximately 75-85% patients have a non-invasive tumour, with a recurrence rate of 31-78%, yet with high 5-year survival of 80-90%.…”

“…2 The incidence rises with age, with the average age at diagnosis being 71 years. 2 At the time of diagnosis in the UK, approximately 75-85% patients have a non-invasive tumour, with a recurrence rate of 31-78%, yet with high 5-year survival of 80-90%. Around 30% are multifocal.…”

“…In contrast, once the tumour has invaded muscle, survival is below 50%. 2 Emergency presentations occur predominately with advanced disease and have a higher mortality. 3 More timely diagnosis of bladder cancer may improve outcomes, either by a favourable stage shift or by avoiding emergency presentations.…”

Prospective evaluation of fluorescence in situ hybridization for diagnosing urothelial carcinoma

“…Over the previous decade, several studies have evaluated the diagnostic value of FISH in UC, but the clinical value and cost-efficiency remains incompletely characterized (17,18). As important data has arisen from case-control designs (19)(20)(21) or focused on BUC or UTUC exclusively (22)(23)(24)(25), the present study was designed to assess the diagnostic value of FISH for detecting UC prospectively, and to evaluate the utility of FISH in association with cytology as a non-invasive diagnostic technique.…”