Bias in Detecting Bladder Cancer Recurrence Assessed

-- A. Agrawal, PhD

Monday, December 28, 2009

MONDAY, Dec. 28 (HealthDay News) -- Patients with bladder cancer and a positive urine test result are more likely to have a recurrence detected by cystoscopy if the urologist is aware of the positive result, according to a study in the January issue of The Journal of Urology.

Madelon N.M. van der Aa, M.D., from Erasmus Medical Center Rotterdam in the Netherlands, and colleagues studied 448 patients with non-muscle invasive (pTa, pT1, G1, G2) urothelial carcinoma who were undergoing a microsatellite analysis urine test. The urologist was informed of the test results in 226 patients, and cystoscopy was performed if the test was positive.

At a median follow-up of 34 months, the researchers found that significantly more recurrences were detected in patients where the urologist was informed of the test results (218 versus 163). Significantly more recurrences were detected among cystoscopies done with the knowledge that the urine test was positive than among those done without information on the positive test result (42 out of 131 versus 6 out of 120). The detection rate of recurrences was similar among patients with a negative urine test regardless of whether the urologist was informed (7 and 6 percent for informed and not informed, respectively).

"Diagnostic review bias should be considered in the evaluation of point of care urine tests for bladder cancer monitoring," van der Aa and colleagues conclude. "Awareness of a positive urine test result significantly improves the urothelial carcinoma detection rate using cystoscopy."

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Specialties Cardiology
Diabetes & Endocrinology
Internal Medicine
Family Practice

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