University of Rochester Urologists: Bladder Cancer Screening Saves Lives

May 22, 2006

Bladder cancer effects about 62,000 people each year in the U.S.

Testing healthy men for hematuria – microscopic amounts of blood in their urine – is a valuable screening tool for bladder cancer and reduces bladder cancer deaths by 20 percent, according to a study by researchers at the University of Rochester Medical Center.

The large, 14-year study of middle-aged and older men provides urologists with much-needed scientific evidence of the benefits of screening for bladder cancer on long-term survival. It is the only U.S. population-based screening study of the disease and results were presented today at the American Urology Association conference in Atlanta, Ga.

Hematuria is the most common predictor of bladder cancer or other urinary-tract disorders. When doctors find it, usually as part of other exams, even if there is no serious condition found, the patient undergoes lengthy follow-up with a variety of tests.

“For years we’ve understood that screening and early detection is the best method for finding some cancers and improving survival, but there weren’t any significant studies to demonstrate that for bladder cancer,” said Edward M. Messing M.D., chair of Urology at the University of Rochester Medical Center and its James P. Wilmot Cancer Center.

Messing and urologist Ralph Madeb, M.D., analyzed bladder cancer rates and deaths for two groups of men. One group of 1,575 men who took part in hematuria screenings from 1987-2002 and the other group was not screened for bladder cancer. The researchers compared cancer incidence and stage of disease when diagnosed

In all, 530 men were diagnosed with bladder cancer. Of those, only 21 came from the group of screened men, and the others, 509 cases, came from the unscreened group. In those 509 cases, most men sought medical attention only after discovering on their own blood in their urine and bladder cancer was diagnosed then, Madeb said.

Of that group, 309 had low-grade surface cancers and 200 had high-grade cancers, 120 of which were already deeply invasive at the time of diagnosis. The study showed 104 of those men died from the disease, including half of the men with the most serious, invasive bladder cancers.

Of the 1,575 men in the screening group, 21 were diagnosed with bladder cancers and none died of bladder cancer during the 14 years of follow-up. Eleven men were found to have low-grade cancer and another ten with high-grade cancer, and only one of those men had an invasive bladder cancer.

“This shows that screening is likely to be effective in saving lives because we found most of the high-grade cancers early enough to provide effective treatments,” said Madeb, who presented results of a companion study of screening and outcomes for microhematuria at the AUA meeting.

Each year, bladder cancer affects about 62,000 people, mostly men, in the United States. Smoking and chemical exposure are the most common risk factors for the disease.

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