According to a recent article published in the Journal of the American Medical Association, the addition of the NMP22® BladderChek® test to cystoscopy improves the detection of recurrent bladder cancer compared to cystoscopy alone.
Bladder cancer is common; approximately 55,000 new cases are diagnosed in the U.S. each year. Superficial bladder cancer refers to cancer that has not spread to muscles of the bladder or nearby lymph nodes. Recurrence of superficial bladder cancer is common and often involves cancer invading the muscle of the bladder. Surgery is then required to remove the cancer.
Patients who have undergone initial treatment for superficial bladder cancer often receive follow-up cystoscopies to detect a recurrence. During a cystoscopy, a physician places a lighted tube into the bladder to search for abnormal areas of tissue that indicate cancer. Since the cystoscope must be inserted into the bladder, cystoscopy is an invasive procedure-a notable limitation of this test. Furthermore, physicians are often unable to detect small cancers or have difficulty visualizing the entire area of cancer during a standard cystoscopy. This leads to incomplete surgical removal of the cancer, increasing the risk of cancer progression and recurrences. Researchers continue to evaluate ways in which to improve the detection of bladder cancers.
The NMP22 BladderChek test measures levels of specific proteins in the urine that are elevated in the presence of bladder cancer. It is easily performed on a urine sample obtained during an office visit. In addition, the test does not need to be sent to a laboratory; it can be performed in any clinical office, and results can be available during the same visit. The BladderChek test is approved for the detection of bladder cancer.
Researchers from several institutions recently conducted a clinical trial to further evaluate the addition of the BladderChek test to cystoscopy in the detection of bladder cancer. This trial included 668 patients from 23 medical facilities who had a prior diagnosis of bladder cancer. Patients underwent the NMP22 BladderChek test and urine cytology (evaluation of shed cells in the urine) prior to cystoscopy. The addition of the NMP22 BladderChek test to cystoscopy improved detection rates of cancer:
- Recurrent bladder cancer was diagnosed in 103 patients.
- Cystoscopy alone detected 91% of bladder cancers.
- Addition of NMP22 BladderChek test to cystoscopy detected 99% of the cancers.
- The NMP22 BladderChek test detected 8 of 9 cancers not detected by cystoscopy, including 7 that were considered aggressive.
- Urine cytology only detected 3 of the cancers missed by cystoscopy.
The researchers concluded that, compared to cystoscopy alone, the addition of the NMP22 BladderChek test to cystoscopy improves the detection rate of recurrent bladder cancer in patients with a history of bladder cancer. Patients who undergo routine screening for the recurrence of bladder cancer may wish to speak with their physician regarding the NMP22 BladderChek test.
Reference: Grossman H, Soloway M, Messing E, et al. Surveillance for Recurrent Bladder Cancer Using a Point-of-Care Proteomic Assay. Journal of the American Medical Association. 2006;295:299-305.