Can Bladder Cancer Be Found Early?

Bladder cancer can sometimes be found early -- when it's small and hasn't spread beyond the bladder. Finding it early improves your chances that treatment will work.

Screening for bladder cancer

Screening is the use of tests or exams to look for a disease in people who have no symptoms. At this time, no major professional organizations recommend routine screening of the general public for bladder cancer. This is because no screening test has been shown to lower the risk of dying from bladder cancer in people who are at average risk.

Some providers may recommend bladder cancer tests for people at very high risk, such as:

• People who had bladder cancer before
• People who had certain birth defects of the bladder
• People exposed to certain chemicals at work

Tests that might be used to look for bladder cancer

Tests for bladder cancer look for different substances and/or cancer cells in the urine.

Urinalysis: One way to test for bladder cancer is to check for blood in the urine ( hematuria). This can be done during a urinalysis, which is a simple test to check for blood and other substances in a sample of urine. This test is sometimes done as part of a general health check-up.

Blood in the urine is usually caused by benign (non-cancer) problems, like infections, but it also can be the first sign of bladder cancer. Large amounts of blood in urine can be seen if the urine turns pink or red, but a urinalysis can find even small amounts.

Urinalysis can help find some bladder cancers early, but it has not been shown to be useful as a routine screening test.

Urine cytology: In this test, a microscope is used to look for cancer cells in urine. Urine cytology does find some cancers, but it's not reliable enough to make a good screening test.

Urine tests for tumor markers: Newer tests look for certain substances in urine that might be a sign of bladder cancer. These include:

• UroVysion™: This test looks for chromosome changes that are often seen in bladder cancer cells.
• BTA tests: These tests look for a substance called bladder tumor-associated antigen (BTA), also known as CFHrp, in the urine.
• ImmunoCyt™: This test looks at cells in the urine for the presence of substances such as mucin and carcinoembryonic antigen (CEA), which are often found on cancer cells.
• NMP22 BladderChek^®: This test looks for a protein called NMP22 (nuclear matrix protein 22) in the urine. People who have bladder cancer often have higher levels .

These tests might find some bladder cancers early, but they can miss some as well. And in some cases, the test result might be abnormal even in people who do not have cancer. At this time, the tests are used mainly to look for bladder cancer in people who already have signs or symptoms of it, or to watch for signs that the cancer has come back (recurred) in people who have had a bladder cancer removed. More research is needed to know if these or other tests are useful as screening tests.

Watching for possible symptoms of bladder cancer

No screening tests are recommended for people at average risk, but bladder cancer can be found early because it causes blood in the urine or other urinary symptoms. (See Bladder Cancer Signs and Symptoms for details.) Many of these symptoms often have less serious causes, but it’s important to have them checked right away so the cause can be found and treated, if needed. If the symptoms are from bladder cancer, finding it early offers the best chance for successful treatment.