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urine test can spot bladder cancer years before diagnosis, study says

typically diagnosed using a painful procedure that requires inserting a camera into the bladder, researchers simply tested urine instead, identifying the genetic mutations most closely linked to bladder cancer.

bladder cancer caught earlier by peeing in a cup
bladder cancer is one of the most common cancers in canada, with an estimated 13,300 canadians receiving a diagnosis in 2022. getty

getting tested for bladder cancer may soon be as simple as peeing into a cup, thanks to a group of researchers who have found a way to identify the disease years before symptoms emerge.

the test, which was  just presented at the european association of urology annual congress in milan , works by identifying mutations across 10 genes that are linked to the most common form of bladder cancer. by searching for evidence of these specific mutations in the urine of patients, researchers were able to predict future cases of cancer up to 12 years before diagnosis and without the use of more costly medical procedures.

“diagnosis of bladder cancer relies on expensive and invasive procedures such as cystoscopy, which involves inserting a camera into the bladder,” said florence le calvez-kelm , lead researcher of the study from the international agency for research on cancer (iarc) in lyon, france. “having a simpler urine test that could accurately diagnose and even predict the likelihood of cancer years in advance could help to spot more cancers at an early stage and avoid unnecessary cystoscopies in healthy patients.”

bladder cancer killed 2500 canadians last year

bladder cancer is one of the most common cancers in canada, with an estimated 13,300 canadians receiving a diagnosis in 2022, according to the canadian cancer society . the disease, which is much more common in men than women, claimed the lives of roughly 2,500 people last year. although only around half of patients diagnosed with an advanced form of the disease survive more than five years, researchers say this figure can rise above 80 per cent if the cancer is detected in its early stages.

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in an attempt to assist these efforts, the team modified a general urine test into one capable of identifying the genetic mutations most closely linked to bladder cancer. they trialled the new test on the golestan cohort study , a database that has tracked the health of more than 50,000 iranians for more than 10 years. all participants were required to provide a urine sample upon enrolment.

forty people included in the database developed bladder cancer over this 10 year period and researchers were able to use their test on 29 of these urine samples, alongside a similar group of 98 control subjects. of these 29 patients, the new test accurately predicted future bladder cancer in 19 (or 66 per cent) of them, despite the fact the urine sample was taken up to 12 years before their eventual diagnosis. of the 14 participants who were diagnosed within seven years of providing a urine sample, the new test predicted 12 (86 per cent) of them.
the test also proved accurately negative in 94 of the 98 control subjects who did not go on to develop bladder cancer. in the cases where the test returned a negative result but the participant went on to develop cancer, no diagnosis was made until at least six years after urine collection.

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the test was also used on 70 bladder cancer patients (and 96 control subjects) from massachusetts general hospital and ohio state university, generally with much more recent urine samples. mutations were found in the urine of 50 of the 70 patients (71 per cent) who had tumours that were identified during a cystoscopy. no mutations were found in 90 of the 96 (94 per cent) patients who showed no tumours on their cystoscopy.
“we’ve clearly identified which are the most important acquired genetic mutations that can significantly increase the risk of cancer developing within 10 years,” said le calvez-kelm. “our results were consistent across two very different groups — those with known risk factors undergoing cystoscopy and individuals who were assumed to be healthy.
“should the results be replicated in larger cohorts, urine tests for these mutations could enable routine screening for high-risk groups, such as smokers or those exposed to known bladder carcinogens through their work.
“this kind of test could also be used when patients come to their doctors with blood in the urine, to help reduce unnecessary cystoscopies. if we can identify bladder cancer early on, before the disease has advanced, then we can save more lives.”

dave yasvinski is a writer with  healthing.ca

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