Screening for bladder cancer: the best opportunity to reduce mortality

Authors

  • Yves Fradet University of Laval, Québec, QC

DOI:

https://doi.org/10.5489/cuaj.1192

Abstract

Bladder cancer kills more women than cervical cancer and is also
a significant cause of mortality in men. Little progress has been
made in improving survival in patients with advanced bladder
cancer. Two pilot studies using microhematuria screening have
shown that screening for bladder cancer results in close to 80%
downstaging, with high-grade cancers being detected before they
have invaded the bladder wall. Results of long-term follow-up
even suggest a striking reduction in bladder cancer mortality. The
main obstacles to screening for bladder cancer may be overcome
if a higher-risk population is identified by designing a risk scale
for exposure to cigarette smoke and occupational carcinogens,
and through genetic testing for susceptibility to cancer and home
hematuria screening, which in itself identifies a population with
approximately 3% to 4% risk of bladder cancer. The feasibility
and cost effectiveness of screening for bladder cancer can be
significantly improved by incorporating a secondary screening
strategy using a more sensitive and specific bladder cancer marker
that is currently available, and by limiting urological evaluations
to patients who show positive results on one or more of these
tests. Bladder cancer is the most costly cancer to treat in the
United States and pharmacoeconomic studies suggest that screening
for bladder cancer could not only save lives but also reduce
costs per year-life saved. A pilot study is underway and the urology
community should be very supportive of studies to validate
this opportunity.

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Author Biography

Yves Fradet, University of Laval, Québec, QC

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How to Cite

Fradet, Y. (2013). Screening for bladder cancer: the best opportunity to reduce mortality. Canadian Urological Association Journal, 3(6-S4), S180-S183. https://doi.org/10.5489/cuaj.1192

Issue

Vol. 3 No. 6-S4 (2009): CUAJ December Suppl 4

Section

Review

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