Home hematuria screening cuts bladder cancer mortality

[unseennude]

Home hematuria screening, with appropriate follow-up and treatment of positive cases, appears to reduce bladder cancer mortality, according to study findings presented this week at the annual meeting of the American Urological Association in Atlanta.

In an earlier study, "we had shown that screening for hematuria at home with chemical reagent strips promoted the detection of bladder cancers at early stages," lead author Dr. Edward M. Messing, from the University of Rochester in New York, told Reuters Health. "Now, we show that it can also reduce bladder cancer mortality."

The current study involved 1575 men who performed home hematuria screening for 14 days, 2 months apart. The outcomes of men with screen-detected bladder cancers were then compared with those of unscreened men with bladder cancer entered in the Wisconsin Cancer Reporting System in 1988.

Twenty-one men in the screened group were found to have bladder cancer and their outcomes were compared with those of 509 men in the Wisconsin database.

Similar proportions of men with high- and low-grade cancers were noted in each cohort. However, just 10% of the high-grade lesions in the screen-detected group were invasive compared with 60% in the unscreened group (p = 0.007).

At a median follow-up period of 14 years, no bladder cancer deaths were noted in the screened group. By contrast, 104 men (20.4%) died from bladder cancer in the unscreened group (p < 0.03) with a median survival period of 1.78 years from diagnosis.

Largely because of the drop in bladder cancer mortality, overall mortality was also lower in the screened group: 43% vs. 74% (p < 0.02).

While the current findings are encouraging, "prospective, randomized trials are needed to confirm the benefits of home hematuria testing," Dr. Messing said. In addition, "since our studies were conducted a number of bladder cancer markers have been identified that may improve the specificity of testing," he added.