Twenty-five per cent of primary bladder cancers are invasive at first diagnosis and one third are high grade. Among patients with a history of bladder cancer, 50 per cent or more have recurrences, and progression of stage or grade occurs in 10-50 per cent.
In patients with muscle invasive disease, a delay in surgery is associated with a more advanced pathological state and poorer prognosis.
If detected early, bladder cancer is highly curable, with 94 per cent of patients surviving five years or more. But about one in four patients are not diagnosed until the cancer has spread, cutting survival in half.
>Matritech's NMP22 BladderChek Test is designed to be used alongside cystoscopy (a visual examination of the bladder with a lighted scope), providing information about the stage and grade of a bladder cancer prior to a biopsy.
Recent tests have demonstrated that when a tumour was seen during cystoscopy and the NMP22 BladderChek Test result was positive, the cancer was almost three times as likely to have progressed into muscle and/or be high grade (aggressive).
Additionally, when a tumour was visible during cystoscopy but the result of the NMP22 BladderChek Test was negative, the cancer had a greater likelihood of being confined to the bladder lining and less aggressive. This was true for both newly diagnosed and recurrent cancers.
"Using the NMP22 BladderChek Test with cystoscopy adds useful information to enhance our ability to detect and treat a cancer. Cystoscopy is very good, but not perfect, that's why physicians use adjunctive tests," said Mark Soloway, chairman of the Department of Urology at the University of Miami Leonard M. Miller School of Medicine.
Until now, there has not been a simple in-office test to reliably diagnose this disease. Symptoms, such as blood in the urine, which could indicate bladder cancer, are treated as suspected (urinary tract) infections for several months before they're diagnosed.
Soloway added that the NMP22 test could also be used as a critical tool for regularly evaluating patients at high risk for bladder cancer: long-time smokers, people who work around particulates in manufacturing, or who work with chemicals like those in hair dyes.
Two recent studies that were published in JAMA (Journal of the American Medical Association) in January 2006 and February 2005, demonstrated that the NMP22 BladderChek Test identified cancers not seen during cystoscopy, either because they were outside the viewing field of the cystoscope or because they were difficult to differentiate from normal tissue.