Urinary markers in screening patients with hematuria.

Hematuria is a common presenting symptom of urothelial malignancy. Although conventional urine analysis is very sensitive in detecting the presence of hematuria, it is not specific in detecting bladder cancer or other urinary-tract cancers. The noninvasive urinary tests NMP22 and UroVysion have been approved by the U.S. Food and Drug Administration for bladder cancer screening. These tests have better sensitivity than cytology for detecting bladder cancer in patients who present with hematuria. The positive predictive values of both tests increase in individuals with hematuria who have risk factors for bladder cancer. Evaluating hematuria with sensitive markers, such as NMP22 and UroVysion, in high-risk populations offers an opportunity to develop effective strategies for bladder cancer screening.