Hematuria Screening for Bladder Cancer

Detection of bladder cancer before deep invasion occurs offers patients a favorable prognosis. Because most bladder cancers, even when noninvasive, produce hematuria, screening asymptomatic persons at risk for bladder cancer for hematuria provides a means of promoting early detection and has the potential to reduce morbidity and mortality. However, bladder cancer-induced hematuria is quite intermittent; thus, repetitive testing is necessary. In a pilot study, 11.4% of asymptomatic men over age 50 who had at least one positive dipstick result were found on urologic work-up to have bladder cancers that were caught early enough to receive purportedly curative treatment. Issues concerning the applicability of this methodology to other high-risk populations are discussed and efforts now underway to confirm and expand upon this screening program are described.