Diagnostic Tests Kit for Bladder Cancer - Medical / Health Care - Clinical Services
Bladder cancer is the seventh most common cancer diagnosis in worldwide, with 500 000 new cases and 200 000 deaths in 2018 (Globocan 2018). More than 2.7 million people have a history of bladder cancer worldwide. At the initial diagnosis of bladder cancer, more than 80% of cases are diagnosed as non-muscle-invasive bladder cancer (NMIBC). Due to the very high recurrence rate (>80%), NMIBC patients require lifelong surveillance with periodic follow-up cystoscopy (an unpleasant invasive exam) and urine cytology (utility limited because cytology has a low sensitivity in detecting low-grade tumors). The bladder cancer is the most expensive cancer.
Details
Risk factors
Tobacco smoking
- Cigarette smoking most important factor related to bladder cancer
- More than 50% due to cigarette smoking
- Confers a twofold increased of bladder cancer than nonsmokers; dose-related
Occupational and environmental exposure
- Carcinogenic chemical substances (e.g., aromatic amines, paints and solvents) represent up to 25% of bladder cancer
- Workers in chemical, petrochemical, plastic, paint and rubber industry
Diagnostic: How is bladder cancer diagnosed?
- Symptoms
- Gross heamturia: Visible blood in the urine
- Miscroscopic hematuria: Presence of microscopic red cells in the urine
- Urinary discomfort
- Frequent urination
- Bladder spasms
Urine cytology
- Laboratory test in wich a sample urine is checked under microscope for abnormal cells
- Cytologist dependent
- Medium sensitivity for high-risk bladder cancer (40-50%)
- Low sensitivity for low-risk bladder cancer (20-40%)
- Low sensitivity for detection of recurrences (38-65%)
Bladder cystoscopy
- Cystoscopy is the gold standard procedure for diagnosis and surveillance of bladder cancer
- Invasive exam, uncomfortable and costly
- Urologist dependent
- High accurate with sensitivity and NPV >95%
- Risks and side effects: swelling of the urethra, blood in urine, pain to urinate, microbial infection
Histology analysis
- Histological analysis performed by the pathologist
- Examination of tissue samples and surgical specimens under a microscope
- Determination whether the tumor is benign or malignant, as well as the malignancy potential
- Bladder cancer classification based on the type, grade and stage