Non-invasive methods of bladder cancer detection.

At present, the gold standard for the detection of bladder carcinoma is cystoscopy, often as part of the investigation of haematuria. There has been substantial research into the development of a non-invasive test for voided urine that would obviate the requirement for flexible cystoscopy. If such a test was 100% sensitive and 100% specific, and was cost-effective, it could represent a way of separating patients who required tumour resection from those with no bladder carcinoma development. This article reviews the development of non-invasive tests for the detection of bladder carcinoma, with emphasis on the most recent developments in fields such as microsatellite analysis, telomerase, and matrix metalloproteinase detection, in addition to the more widely researched tests such as NMP22 and BTA.