2024-07-10 16:58:12
A new urine test could spare bladder cancer survivors from a painful follow-up procedure needed to make sure their cancer hasn’t returned, researchers report.
People who have had surgery for high-risk bladder cancer require a cystoscopy, a procedure in which a flexible tube is inserted through the urethra into the bladder, allowing doctors to detect signs of recurrent cancer.
“We know that many patients really fear their cystoscopy appointments, but are prepared to go through with them because they want to be sure they are cancer-free,” said researcher Dr. Thomas Dreyer, of the Bladder Cancer Research Team at Aarhus University Hospital in Denmark.
But new research shows that a urine test looking for genetic markers for bladder cancer can more than halve the number of cystoscopies needed to follow up high-risk patients.
Only 44 percent of patients who underwent urinalysis needed a cystoscopy, compared with nearly 100 percent of patients who received standard care.
The trial also produced strong evidence that urine testing can detect recurrent cancer earlier than a cystoscopy.
For more than half of the patients who appeared to have a “false positive” (in which the urine test found genetic evidence of cancer, but a follow-up cystoscopy was clear), researchers later found that their cancer had returned.
“If given the option of providing a urine sample rather than undergoing an uncomfortable medical procedure, most would choose that, as long as they were confident it was just as effective,” Dreyer said.
The clinical trial included the Xpert Bladder Cancer Monitor test, which looks for five genetic markers of bladder cancer. The trial was funded by Cephied, the company that makes the Xpert test.
The study was conducted in Denmark, where patients with high-risk bladder cancer who have undergone surgery are recommended to undergo a cystoscopy every four months for two years.
High-risk patients with the most aggressive form of bladder cancer have a 60 to 70 percent chance that their cancer will return within five years, the researchers noted in background notes.
For the trial, researchers recruited 313 Danish patients and randomly assigned half of them to receive only an annual cystoscopy for two years. For the other regular checkups, these patients provided a urine sample.
All patients who received a positive result on their urine test returned to the hospital for a cystoscopy to detect cancer.
The other half continued to receive the three standard cystoscopies per year.
The researchers presented the first promising results at this year’s European Association of Urology Congress in Paris. Full results are expected in the summer.
“This trial shows us a possible way to reduce cystoscopies,” Dr. Joost Boormans, associate professor of urology at Erasmus University Medical Center in Rotterdam, the Netherlands, said in a meeting news release.
“If the final results from this year confirm that the urine test can detect cancer recurrence as effectively as cystoscopies, then this is something we should consider introducing into clinical practice as soon as possible, because it reduces the demand on our resources and helps make healthcare more accessible,” added Boormans, who was not involved in the study.
Because these results were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.
More information
The American Cancer Society offers more information about bladder cancer.