Urine test improves detection of recurrent bladder cancer

The NMP22 test (BladderChek, Matritech, Newton, MA) significantly increased the detection of recurrent bladder cancer, finding 99% of the malignancies when used with cystoscopy, according to a study published this week in JAMA (2006; 295:299-305). The test was positive for eight of nine tumors not seen by cystoscopy, including seven that were aggressive or advanced. It also detected four times as many cancers as urine cytology, researchers reported.

The authors, led by H. Barton Grossman, MD, of M.D. Anderson Cancer Center, Houston, recommend using the test in the routine monitoring and management of bladder cancer patients. Unlike cell-based urine tests, it does not require laboratory time and facilities and expert analysis.

"NMP22 BladderChek combined with cystoscopy detects significantly more cancers than cystoscopy alone. Because bladder cancer has a very high recurrence rate, we need to monitor patients vigilantly. Adding the NMP22 test to routine monitoring provides an extra measure of confidence," Dr. Grossman said.

The multicenter study, conducted from September 2001 to February 2002, enrolled 668 patients with a history of bladder cancer. Prior to undergoing cystoscopy, patients provided a urine sample for analysis of NMP22 and for cytology testing. Bladder cancer was diagnosed in 103 patients. Cystoscopy alone identified 91.3% of the cancers. The combination of cystoscopy with the NMP22 assay detected 99% of the malignancies.