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Bladder cancer can sometimes be found early. Finding it early
improves your chances that it can be treated successfully.
Screening
Screening tests or exams are used to look for a disease in
people who have no symptoms (and who have not had that disease before).
One possible way to screen for bladder cancer is to check for
blood in the urine (called hematuria).
Blood in the urine is usually caused by benign conditions such as
infections, but it can be the first sign of bladder cancer. Although
large amounts of blood are can easily be seen, a test is needed to find
small amounts. The test most often used is called urinalysis. But most
studies of screening by using routine urinalysis to look for blood
haven’t found more bladder cancers, although one study found
that screening might detect the cancer at an earlier stage.
Another way to screen for bladder cancer is to examine the
urine for cancer cells (urine cytology). This test does find some
cancers, but it is not reliable enough to make a good screening test.
A newer test looks for a substance called NMP22 in the urine.
When used in a large group of people being checked for bladder cancer,
about half of the people found to have bladder cancer had abnormal
results on this test. The people being checked either had symptoms of
bladder cancer (such as blood in the urine) or were at high risk of
bladder cancer because they smoked. The NMP22 test did find a few cases
of bladder cancer that were missed by cystoscopy (this procedure is
described in "How
is bladder cancer diagnosed?"). Still, some people with
abnormal results did not actually have cancer at all, and this test
missed almost half of the cases of bladder cancer. Right now, the test
for NMP22 seems to be better suited for use in patients who have had a
bladder cancer removed to check for cancer recurrence.
Another promising test looks for telomerase in the urine.
Telomerase is an enzyme that is found often in cancer cells. Still,
experts feel that more studies need to be done before any test becomes
useful for widespread screening for bladder cancer.
Screening the general public for bladder cancer is not recommended
by any professional organization. Some doctors recommend bladder cancer
screening for people at very high risk. Risk factors that would justify
screening include a previous diagnosis of bladder cancer or certain
birth defects of the bladder. People with a lot of work-related
exposure to certain chemicals might also be screened. This has been
done in the past, usually by a combination of microscopic examination
of urine for cancer cells (urine cytology) and viewing the bladder
through a thin lighted tube (cystoscopy).
If you don't have any known risk factors, prompt attention to
bladder symptoms is the best advice for finding bladder cancer in its
earliest, most treatable stages.
Last Medical Review: 01/27/2009
Last Revised: 5/13/2009
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