Comparison of bladder cancer outcome in men undergoing hematuria home screening versus those with standard clinical presentations

doi:10.1016/S0090-4295(99)80006-5

Urology

Volume 45, Issue 3, March 1995, Pages 387-397

https://doi.org/10.1016/S0090-4295(99)80006-5 Get rights and content

Abstract

Objectives

Because repetitive hematuria home screening with a chemical reagent strip can detect early stage bladder cancer (BC) in asymptomatic middle-aged and elderly men, the ability of this screening to effect earlier detection and reduce BC mortality was investigated.

Methods

Grades, stages, and outcomes of BCs detected by hematuria screening in 1575 men were compared with those of all newly diagnosed BCs in men age 50 years or older reported to the Wisconsin cancer registry in 1988. BC grades and stages were assigned by review of all pathology slides/blocks, and causes of deaths were determined from cancer registry records. As an additional control group, outcomes of BC cases diagnosed in men solicited to take part in screening, who declined, were also determined.

Results

The proportions of low-grade (grades 1 and 2) superficial (Stages Ta and T1) versus high-grade (grade 3) or invasive (Stage T2 or higher) cancers in cases detected by hematuria screening (screened cases) and those reported to the tumor registry (unscreened cases) were not significantly different (52.4% versus 47.7% in 21 screened and 56.8% versus 43.3% in 511 unscreened cases) (P > 0.20). Of the high-grade or invasive cases, however, the proportion of late stage (T2 or higher) tumors was significantly lower in the screening-detected BCs compared to unscreened ones (P = 0.007). No screened case has died of BC (3- to 9-year follow-up), whereas 16.4% of unscreened cases have within 2 years of diagnosis (P = 0.025). Twenty-three of 1940 (1.2%) men who were solicited but chose not to participate in screening were diagnosed with BC within 18 months after what would have been their last home screening date, compared with 1.3% of participants having BC detected by screening. Thus, screening participants and those who were solicited and declined had similar likelihoods of developing BC.

Conclusions

Hematuria home screening detects high-grade cancers before they become muscle invading and significantly reduces BC mortality.

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^*: This project is supported in part by the Wisconsin Division of Health, Department of Health and Social Services, Madison, Wisconsin, and Miles, Inc., Elkhart, Indiana.

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Comparison of bladder cancer outcome in men undergoing hematuria home screening versus those with standard clinical presentations*

Abstract

Objectives

Methods

Results

Conclusions

J Urol

J Urol

J Urol

J Urol

J Urol

J Urol

J Urol

Monogr Urol

Urol Clin North Am

Ca

Cancer

J Urol

Cancer statistics, 1992: CA Cancer J Clin

Superficial bladder cancer treated with bacillus Calmette-Guerin: a multivariate analysis of factors affecting tumor progression

J Urol

Early stage bladder cancer

Wis Med J

Results of contemporary radical cystectomy for invasive bladder cancer: a clinicopathological study with an emphasis on the inadequacy of the tumor, nodes and metastases classification

J Urol

Hematuria screening for bladder cancer

J Occup Med

Symposium on bladder tumors; current clinical problems regarding bladder tumors

Urinary tract cancers found by homescreening with hematuria dipsticks in healthy men over 50 years of age

Cancer

Hematuria home screening: repeat testing 9 months after negative tests

J Urol

Hematuria home screening: repeat testing 9 months after negative tests

J Urol