Inclusion of a molecular marker of bladder cancer in a clinical pathway for investigation of haematuria may reduce the need for cystoscopy

Resource type
Authors/contributors
Title
Inclusion of a molecular marker of bladder cancer in a clinical pathway for investigation of haematuria may reduce the need for cystoscopy
Abstract
AIM: To examine prospectively the impact of adding a urinary biomarker of bladder cancer (Cxbladder TriageTM, CxbT) to a clinical pathway for investigating haematuria. METHODS: The clinical outcome of 571 patients with haematuria who presented to their general practitioner was reviewed. Outcome measurements included the findings of laboratory tests, imaging, cystoscopies, histology and specialist assessments. The data were used to model a theoretical clinical pathway that involved initial screening using CxbT in combination with imaging, and only test positive patients being referred for specialist assessment and cystoscopy. RESULTS: All patients underwent cystoscopy and 44 transitional cell carcinomas were diagnosed in the study cohort, with two low-risk cancers missed by CxbT, one of which was also not detected by imaging. When combined, imaging and CxbT had a sensitivity of 97.7% and negative predictive value of 99.8%. CONCLUSIONS: In our series, all significant bladder cancers were diagnosed by imaging and CxbT before cystoscopy was undertaken. The high negative predictive value of this clinical pathway would allow approximately one-third of patients with haematuria to be managed without cystoscopy.
Publication
The New Zealand Medical Journal
Volume
132
Issue
1497
Pages
55-64
Date
Jun 21, 2019
Journal Abbr
N. Z. Med. J.
Language
eng
ISSN
1175-8716
Library Catalog
PubMed
Extra
PMID: 31220066
Citation
Davidson, P. J., McGeoch, G., & Shand, B. (2019). Inclusion of a molecular marker of bladder cancer in a clinical pathway for investigation of haematuria may reduce the need for cystoscopy. The New Zealand Medical Journal, 132(1497), 55–64. https://www.nzma.org.nz/journal-articles/inclusion-of-a-molecular-marker-of-bladder-cancer-in-a-clinical-pathway-for-investigation-of-haematuria-may-reduce-the-need-for-cystoscopy
Processing time: 0.02 seconds