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  • Early detection of bladder cancer can improve clinical outcomes and survival rates, similar to other cancers.
  • One current area of research involves looking at cell mutations in areas where cancer may occur to predict the likelihood of it occurring in the future.
  • A recent study showed a urine test could be used to detect 10 specific genes that could help predict bladder cancer.

B​ladder cancer is the 10th most common cancer worldwide and the fourth most prevalent cancer among men. The disease develops when bladder tissue cells begin to separate uncontrollably.

Malignant bladder cancer can spread quickly and may be life threatening. Early detection and identifying those most at risk are crucial to improving outcomes for people with bladder cancer.

A​ study found that gene mutations could be detected using urine samples and could be used to effectively predict bladder cancer up to 12 years before diagnosis. Researchers shared the study results at the European Association of Urology (EAU) annual Congress. Authors say further research is needed but suggest their test could help to stratify risk for patients presenting with blood in their urine, for example.

B​ladder cancer is a common type of cancer, impacting about 1 in 28 men and 1 in 91 women during their lifetime. Bladder cancer survival rates are highest if the cancer is localized to cells lining the inside of the bladder or has not spread beyond the bladder. Thus early detection and diagnosis are critical components of effective treatment.

While anyone can develop bladder cancer, certain risk factors can increase someone’s likelihood of developing bladder cancer. People can modify some factors, such as quitting smoking or increasing fluid intake. However, people cannot change factors like family history or specific gene mutations. Researchers are still seeking to understand the full scope of gene mutations contributing to bladder cancer risk.

Non-study author Dr. Jennifer Linehan, urologist and associate professor of urology and urologic oncology at the Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica offered the following insights into bladder cancer to Medical News Today:

“Bladder cancer, like many cancers, has a low grade and a high grade version, which can drastically alter the outcomes and treatments for patients. The most significant issue with both low or high grade bladder cancer is a high recurrence rate which in some studies can be as high as 60% in both categories, and if the cancer is muscle invasive then this drastically changes treatment to either needing chemo and radiation or removing the bladder via radical cystectomy and urinary diversion.”

Researchers in this study utilized urine samples to look at specific gene mutations. T​hey started their research using the UroAmp test, which can examine mutations in sixty genes. From here, they looked at a subset of ten genes that they believed would be the most beneficial in predicting bladder cancer.

N​on-study author, Dr. Michael Johnson, a Washington University urologist at Siteman Cancer Center, explained the usefulness of looking into this subset of mutations:

“[Study authors] took urine samples from patients with bladder cancer and controls (e.g. no bladder cancer) and performed genomic profiling. They analyzed 60 genes for mutations, ultimately finding the 10 most predictive genes. A smaller set may be advantageous so they can do the test faster/cheaper. They tested their panel of genes on other samples and found that they may be able to detect patients who had cancer. Additionally, they may be able to identify patients who are likely to have worse outcomes.”

Researchers ultimately looked at 29 individuals in the data collection that developed bladder cancer. The modified UroAmp test accurately predicted the development of bladder cancer in 66% of participants up to twelve years before participants received a clinical diagnosis. It also predicted bladder cancer in 86% of participants up to seven years before clinical diagnosis.

T​his test was more accurate than its comparison test. In addition, the test accurately predicted a lack of bladder cancer in controls 96% of the time.

While urine tests for bladder cancer are available, this test could increase the specificity and the range of what specialists can detect.

Non-study author Dr. Linehan explained to MNT:

“​This study is important if we can identify more targeted mutations in urine and provide more comprehensive testing which can aid in bladder cancer identification. Currently the urine tests we have only evaluate for a select number of genetic mutations, and by adding more targets we could potentially identify more cancers earlier, saving patients from invasive treatment.”

T​his study did have certain limitations. It only included a limited number of participants, so further research can include more participants to offer a broader scope of data. This test may not be practical in typical clinical practice without further research.

D​r. Johnson offered the following words of caution and discussed potential barriers to using this test in routine clinical practice:

“Lots of research needs to be done before it’s ready for routine practice. Foremost, these tools need to be validated on a larger population. We’ll have to see how this tool performs on patients of different ethnicities, ages, and stages of cancer. Also, these tests will add extra cost to the healthcare system. Insurance coverage may be challenging, especially when patients do not have a diagnosis of bladder cancer. So, further cost-effectiveness across a healthcare system will be needed.”

Regardless, the study opens up the possibility of early detection and prediction of bladder cancer, hopefully increasing the chances of early intervention and treatment.

Study author Trevor G. Levin, Ph.D. noted to MNT:

“While further larger studies will be needed, this study provides an important genetic advance in understanding how bladder cancer develops. Impressively, mutations acquired over life and that give rise to cancer cancer can be detected non-invasively in urine years ahead of a clinical diagnosis. This provides a potential critical window of opportunity to identify high risk patients and to intervene earlier, when cancers can be cured.”