• Posted April 8, 2024

Urine Test Could Cut Need for Painful Bladder Cancer Procedure

A new urine test could spare bladder cancer survivors from a painful follow-up procedure needed to ensure their cancer hasn't come back, researchers report.

People who've gotten surgery for high-risk bladder cancer require a cystoscopy -- a procedure in which a flexible probe is inserted through the urethra into the bladder, allowing doctors to check for signs of recurring cancer.

“We know that many patients really dread their cystoscopy appointments, but are prepared to go through with them because they want to be sure they are free of the cancer,” said researcher Dr. Thomas Dreyer, with the Bladder Cancer Research Team at Aarhus University Hospital in Denmark.

But the new research shows a urine test looking for genetic markers of bladder cancer can more than halve the number of cystoscopies needed to follow up with high-risk patients.

Only 44% of patients who took the urine test needed a cystoscopy, compared to nearly 100% of patients receiving standard treatment.

The trial also produced strong evidence that the urine test can detect recurring cancer earlier than a cystoscopy.

For more than half the patients who appeared to have a “false positive” test -- where the urine screening found genetic evidence of cancer but a follow-up cystoscopy was clear -- researchers later found that their cancer had indeed come back.

“If given the option of providing a urine sample instead of undergoing an uncomfortable medical procedure, most would choose that, so long as they were confident that it was just as effective,” Dreyer said.

The clinical trial involved the Xpert Bladder Cancer Monitor test, which looks for five genetic markers of bladder cancer. The trial was funded by Cephied, the company that manufactures the Xpert test.

The study occurred in Denmark, where high-risk bladder cancer patients who've undergone surgery are recommended to receive a cystoscopy every four months for two years.

High-risk patients with the most aggressive form of bladder cancer have a 60% to 70% likelihood that their cancer will return within five years, researchers said in background notes.

For the trial, researchers recruited 313 Danish patients and randomly assigned half of them to receive only one annual cystoscopy for two years. For the other regular check-ups, these patients instead provided a urine sample.

Any patients who received a positive result on their urine test returned to the hospital for a cystoscopy, to check for cancer.

The other half continued to receive the standard three cystoscopies a year.

Researchers presented the promising early results at this year's European Association of Urology Congress, which took place in Paris. Full results are expected in the summer.

“This trial shows us a possible means of reducing cystoscopies,” Dr. Joost Boormans, an associate professor of urology at Erasmus University Medical Center in Rotterdam, The Netherlands, said in a meeting news release.

“If the final results later this year do confirm that the urine test can pick up cancer recurrence as effectively as cystoscopies, then this is something we need to look at introducing into clinical practice as soon as possible, because it reduces demand on our resources and helps to 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 has more about bladder cancer.

SOURCE: European Association of Urology, news release, April 6, 2024