Telomerase and other novel approaches to bladder cancer detection.

The current protocols in place for bladder cancer screening are cystoscopy and urine cytology. Cytology does not have an adequate sensitivity in low-grade malignancy and has limited utility in the screening and management of bladder cancer patients. Urine tumor markers aimed at detection of cancer via voided urine are an attractive alternative to cytology. Currently, FDA-approved tumor marker assays lack the characteristics of an ideal test and have yet to revolutionize bladder cancer detection. Novel tumor markers, not yet FDA-approved, have the potential to change disease management algorithms that currently include voided urine cytology. Telomerase, an enzyme present in greater than 80% of all cancer cells, has the potential to be a successful bladder tumor marker for cancer surveillance and monitoring.