Comparative study of screening techniques used in early detection of urinary bladder cancer
- Urology & Nephrology Open Access Journal
Sami A Abbas
Background: Early detection of urinary bladder cancer can help improve patients’ outcomes. Detection and follow-up for recurrence by cystoscopy and histopathology of obtained biopsies is costly and causes discomfort to patients. There is a need to find sensitive, specific screening techniques as alternatives to reduce the frequency or to improve the sensitivity for detection of early bladder cancer.
Objective: This study aimed to compare bladder washing cytology (BWC), bladder tumor antigen (BTA), flowcytometry (FCM), and photodynamic diagnosis (PDD) for early detection of urinary bladder cancer.
Methods: This prospective cohort study was conducted on 75 patients with hematuria/cystitis or previous resection of bladder cancer. The four diagnostic techniques were performed in every patient. The results of the studied techniques were compared to the histopathological findings in these patients. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated.
Results: The BWC and PDD showed the highest accuracy (each was 77.3%). The PPD technique had the highest sensitivity and NPV (91.3% and 94.9%, respectively), while the BWC had the highest specificity and PPV (92.3% and 71.4%, respectively). Sensitivity was higher in high grade tumors than the low grades in BWC, while sensitivity was higher in the low-grade tumors than the high grades in the other techniques.
Conclusions: The BWC and PDD had the highest accuracy for detection of bladder cancer. Their combined use is recommended to obtain high sensitivity and specificity.
bladder wash cytology, bladder tumor antigen, flowcytometry, photodynamic diagnosis, urinary bladder cancer