Bladder cancer diagnosis:rapid results using POCT

Each year around 10,000 people in the UK are diagnosed with bladder cancer – it is the fifth most common cancer and is three to four times more common in men than in women. Urothelial carcinoma compromises up to 90% of all primary bladder tumours and more than 70% do not invaded the muscle of the bladder wall. The recurrence rate for these patients is very high and some patients progress to muscle-invasive bladder cancer or metastatic disease.

Bladder cancer is usually identified on the basis of visible blood in the urine or voiding symptoms (pain on urination) but emergency admission is a common way for bladder cancer to present, and is often associated with a poor prognosis. The National Cancer Intelligence Network (NCIN) Routes to Diagnosis project in 2013 found that 16% of men and 24% of women diagnosed with bladder cancer in 2006–2010 were diagnosed via an emergency route. Therefore, methods for early detection and regular follow-up of patients with a history of bladder cancer are of great importance in order to improve the prognosis for patients.

The most common methods for detection of bladder cancer and for the assessment of recurrence are cystoscopy and urine cytology. Cystoscopy causes pain and discomfort in patients and in cases with small, flat urothelial lesions or carcinoma in situ (CIS), a diagnosis is not readily achieved. Urine cytology, a non-invasive urine test, is the standard method for detection of bladder cancer and is recommended as an adjunct to cystoscopy. However, even if cytology has the advantage of high specificity, its sensitivity for well-differentiated or low-grade tumours is low. To overcome such shortcomings of the existing diagnostic methods for bladder cancer, urine tumour markers are available.