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 journalArticle

30 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 1 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

    Zlotta, A. R., Roumeguere, T., Kuk, C., Alkhateeb, S., Rorive, S., Lemy, A., Van Der Kwast, T. H., Fleshner, N. E., Jewett, M. A. S., Finelli, A., Schulman, C., Lotan, Y., Shariat, S. F., & Nortier, J. (2011). Select screening in a specific high-risk population of patients suggests a stage migration toward detection of non-muscle-invasive bladder cancer. European urology, 59(6), 1026-1031. https://doi.org/10.1016/j.eururo.2011.03.027