Is urinary cholesterol determination a possible screening test for urological carcinomas?

It has been suggested that the determination of urinary cholesterol may be of possible value in the diagnosis of urogenital carcinomas, especially of the prostate, kidney and bladder, but it has not proven whether this method could be used as a screening test in large numbers of patients. 430 males and 545 females over 50 years old were selected for the study. Total urinary cholesterol values exceeding the upper 3 SD limit of 5. 1 mg/24 h (regarded as positive results) were present in 13 males (3%) and 9 females (1.6%). Besides benign diseases of the kidney and the urogenital tract, 2 carcinomas of the bladder and 1 carcinoma of the kidney were detected in the male group with elevated urinary cholesterol excretion. In view of the expensive methodology and most importantly because of the low prevalence of urological carcinomas in unselected populations this method cannot be recommended as a primary screening test. This does not exclude the possibility that urinary total cholesterol determinations could be successfully applied in preselected populations with an increased prevalence of urological carcinomas.