Home urine testing cuts bladder cancer deaths

A test for blood in the urine, which is easily performed at home, can lead to the detection of bladder cancers at an earlier, more curable stage, according to study findings presented this week at the annual meeting of the American Urological Association in Atlanta.

The test involves a chemical strip that changes color when placed in urine containing blood. While the test misses very few bladder cancers, it may also pick up non-cancerous disease that can cause blood in the urine, such as kidney stones.

In an earlier study, "we had shown that screening for (blood in the urine) at home with chemical reagent strips promoted the detection of bladder cancers at early stages," lead author Dr. Edward M. Messing, from the University of Rochester in New York, told Reuters Health. "Now, we show that it can also reduce bladder cancer" deaths.

The current study involved 1575 men who performed home urine screening for 14 days, 2 months apart. The outcomes of men with screen-detected bladder cancers were then compared with those of unscreened men with bladder cancer entered in the Wisconsin Cancer Reporting System in 1988.

Twenty-one men in the screened group were found to have bladder cancer and their outcomes were compared with those of 509 men in the Wisconsin database.

Similar proportions of men with aggressive cancers were noted in each cohort. However, just 10 percent of the aggressive cancers in the screen-detected group actually invaded the bladder wall compared with 60 percent in the unscreened group. Once the cancer has invaded the bladder wall, the surgery used becomes more complicated and the chance for cure drops.

At a follow-up period of around 14 years, no bladder cancer deaths were noted in the screened group. By contrast, 20 percent of men died from bladder cancer in the unscreened group with a survival period of about 1.8 years from diagnosis.

Largely because of the drop in bladder cancer deaths, the overall death rate was also lower in the screened group: 43 versus 74 percent.

While the current findings are encouraging, specially designed comparison "trials are needed to confirm the benefits of home (urine) testing," Messing said. In addition, "since our studies were conducted a number of bladder cancer markers have been identified that may improve the specificity of testing," allowing doctors to differentiate bladder cancer from kidney stones, he added.