Select screening in a specific high-risk population of patients suggests a stage migration toward detection of non-muscle-invasive bladder cancer

Alexandre R. Zlotta, Thierry Roumeguere, Cynthia Kuk, Sultan Alkhateeb, Sandrine Rorive, Anne Lemy, Theodorus H. Van Der Kwast, Neil E. Fleshner, Michael A S Jewett, Antonio Finelli, Claude Schulman, Yair Lotan, Shahrokh F. Shariat, Joelle Nortier

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Background: More than 25% of bladder cancer (BC) cases are still muscle-invasive at first diagnosis. Screening is unproven to enable the detection of more non-muscle-invasive tumors. BC association with aristolochic acid nephropathy (AAN) was reported after intake of slimming pills containing Chinese herbs. Objective: We evaluated whether a BC screening protocol in a high-risk and unique patient population had an impact on the stage of tumor presentation. Design, setting, and participants: Forty-eight AAN-affected patients were enrolled in a screening program, establishing BC incidence during prospective screening cystoscopies and biopsies biannually for up to 10 yr. Two patients were lost to follow-up, and three refused screening after consenting. Measurements: Patients were evaluated for presence of BC and tumor stage at diagnosis. Results and limitations: BC was diagnosed in 25 patients (52%). Among 43 patients who underwent screening cystoscopies (median follow-up: 94 mo), 22 were first diagnosed with non-muscle-invasive BC but none with muscle-invasive tumors and none died of BC. Three women who declined follow-up were diagnosed and died with advanced metastatic disease. The limitations of our findings include the small sample size of this case series, the absence of a real control group, and the particular risk factor in these patients that differs from the usual risk factors, such as smoking or industrial chemicals. Conclusions: BC screening in high-risk groups may allow identification of tumors before muscle invasion. The optimal screening schedule and the relevance of the present findings in smoking-related BC remain to be defined.

Original languageEnglish (US)
Pages (from-to)1026-1031
Number of pages6
JournalEuropean urology
Volume59
Issue number6
DOIs
StatePublished - Jun 2011

Keywords

  • Bladder cancer
  • Muscle invasion
  • Screening
  • Stage

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Select screening in a specific high-risk population of patients suggests a stage migration toward detection of non-muscle-invasive bladder cancer'. Together they form a unique fingerprint.

Cite this