BACKGROUND: We previously reported the preliminary findings from a feasibility study of bladder cancer (BCa) screening with urinary molecular markers (Bladder Cancer Urine Marker Project [BLU-P]) that has now been terminated. OBJECTIVE: To report the final results from BLU-P to determine whether mass screening for BCa is feasible and useful. DESIGN, SETTING, AND PARTICIPANTS: BLU-P was a Dutch population-based study initiated in 2008 to evaluate BCa screening. A total of 6500 men were invited to participate in the study, 1984 (30.5%) agreed, and 1747 (88.1%) men completed the protocol and were followed for 2 yr. INTERVENTION: The screening protocol included home hematuria testing followed by molecular markers-nuclear matrix protein 22 (NMP22), microsatellite analysis (MA), fibroblast growth factor receptor 3 (FGFR3) mutation snapshot assay, and a custom methylation-specific (MLPA) test-to determine the need for cystoscopy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Outcomes included the number of cystoscopies and the cancer detection rate within and outside the protocol, as determined by linkage to national registries. RESULTS AND LIMITATIONS: Overall, 409 men (23.4%) tested positive for hematuria and underwent molecular testing. Current smokers (n=295 [17%]) and past smokers (n=998 [58%]) were significantly more likely to test positive for hematuria than nonsmokers. Seventy-one of 75 men (94.6%) with positive molecular markers underwent the recommended cystoscopy. Four BCas and one kidney tumor were detected through this sequential protocol, whereas one BCa and one kidney tumor were missed through the screening program. Limitations include the possibility of healthy subject bias. CONCLUSIONS: For BCa screening, use of a sequential protocol with home hematuria testing followed by molecular markers substantially reduced the number of cystoscopy recommendations compared with dipstick testing alone. A sequential screening approach may help minimize unnecessary invasive follow-up testing, with very few missed cancers. Nevertheless, this mass screening program had a very low diagnostic yield in an unselected asymptomatic European male population.
BACKGROUND: We previously reported the preliminary findings from a feasibility study of bladder cancer (BCa) screening with urinary molecular markers (Bladder Cancer Urine Marker Project [BLU-P]) that has now been terminated. OBJECTIVE: To report the final results from BLU-P to determine whether mass screening for BCa is feasible and useful. DESIGN, SETTING, AND PARTICIPANTS: BLU-P was a Dutch population-based study initiated in 2008 to evaluate BCa screening. A total of 6500 men were invited to participate in the study, 1984 (30.5%) agreed, and 1747 (88.1%) men completed the protocol and were followed for 2 yr. INTERVENTION: The screening protocol included home hematuria testing followed by molecular markers-nuclear matrix protein 22 (NMP22), microsatellite analysis (MA), fibroblast growth factor receptor 3 (FGFR3) mutation snapshot assay, and a custom methylation-specific (MLPA) test-to determine the need for cystoscopy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Outcomes included the number of cystoscopies and the cancer detection rate within and outside the protocol, as determined by linkage to national registries. RESULTS AND LIMITATIONS: Overall, 409 men (23.4%) tested positive for hematuria and underwent molecular testing. Current smokers (n=295 [17%]) and past smokers (n=998 [58%]) were significantly more likely to test positive for hematuria than nonsmokers. Seventy-one of 75 men (94.6%) with positive molecular markers underwent the recommended cystoscopy. Four BCas and one kidney tumor were detected through this sequential protocol, whereas one BCa and one kidney tumor were missed through the screening program. Limitations include the possibility of healthy subject bias. CONCLUSIONS: For BCa screening, use of a sequential protocol with home hematuria testing followed by molecular markers substantially reduced the number of cystoscopy recommendations compared with dipstick testing alone. A sequential screening approach may help minimize unnecessary invasive follow-up testing, with very few missed cancers. Nevertheless, this mass screening program had a very low diagnostic yield in an unselected asymptomatic European male population.
Authors: Michela de Martino; Shahrokh F Shariat; Sebastian L Hofbauer; Ilaria Lucca; Christopher Taus; Helene G Wiener; Andrea Haitel; Martin Susani; Tobias Klatte Journal: World J Urol Date: 2014-02-23 Impact factor: 4.226
Authors: Jean V Joseph; Ralph Brasacchio; Chunkit Fung; Jay Reeder; Kevin Bylund; Deepak Sahasrabudhe; Shu Yuan Yeh; Ahmed Ghazi; Patrick Fultz; Deborah Rubens; Guan Wu; Eric Singer; Edward Schwarz; Supriya Mohile; James Mohler; Dan Theodorescu; Yi Fen Lee; Paul Okunieff; David McConkey; Hani Rashid; Chawnshang Chang; Yves Fradet; Khurshid Guru; Janet Kukreja; Gerald Sufrin; Yair Lotan; Howard Bailey; Katia Noyes; Seymour Schwartz; Kathy Rideout; Gennady Bratslavsky; Steven C Campbell; Ithaar Derweesh; Per-Anders Abrahamsson; Mark Soloway; Leonard Gomella; Dragan Golijanin; Robert Svatek; Thomas Frye; Seth Lerner; Ganesh Palapattu; George Wilding; Michael Droller; Donald Trump Journal: Bladder Cancer Date: 2018-10-03
Authors: Alessandro Sciarra; Giovanni Di Lascio; Francesco Del Giudice; Pier Paolo Leoncini; Stefano Salciccia; Alessandro Gentilucci; Angelo Porreca; Benjamin I Chung; Giovanni Di Pierro; Gian Maria Busetto; Ettore De Berardinis; Martina Maggi Journal: Curr Urol Date: 2021-03-29