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Most people referred for blood in the urine do not have bladder cancer, yet all get cystoscopy. A urine DNA or methylation test could safely spare most of them.
Most people referred with blood in the urine do not have bladder cancer, yet all undergo cystoscopy, so this idea uses a urinary DNA methylation or mutation test to decide who needs the camera test. Biomarker-negative patients would be randomised to deferred versus immediate cystoscopy, with missed muscle-invasive cancer as the safety endpoint and cystoscopies avoided as the efficacy endpoint. Cystoscopy capacity is a rate-limiting step for urology worldwide and urinary assays report high negative predictive value, so safe triage could spare most patients. The test is a 3,000-patient RCT with a pre-agreed non-inferiority margin. At early-clinical maturity it addresses the bottlenecks The hardest cancers are found late and Overdiagnosis and false alarms.
Shares Early detection of cancer, Positive predictive value (PPV), The hardest cancers are found late.
Shares Urine tests for bladder cancer (cytology, FISH, RNA and methylation), DNA methylation profiling, Liquid biopsy (ctDNA), Bladder & urothelial cancer.
Shares Early detection of cancer, Positive predictive value (PPV), The hardest cancers are found late.
Shares Early detection of cancer, The hardest cancers are found late, Liquid biopsy (ctDNA).
Shares Positive predictive value (PPV), DNA methylation profiling, The hardest cancers are found late.
Shares Early detection of cancer, Positive predictive value (PPV), Overdiagnosis and false alarms, The hardest cancers are found late.
Shares Early detection of cancer, The hardest cancers are found late, Liquid biopsy (ctDNA).
Shares Early detection of cancer, The hardest cancers are found late.