Screening for bladder cancer

2017 ◽  
Author(s):  
Maree Brinkman ◽  
Maurice Zeegars
Keyword(s):  
Bladder Cancer ◽  
Screening Tools ◽  
Treatment Modalities ◽  
Urinary Cytology ◽  
Urological Malignancies ◽  
Increased Risk ◽  
Urological Symptoms ◽  
Disease Specific Mortality ◽  
Asymptomatic Individuals

Bladder cancer (BC) is one of the most common urological malignancies and ranks ninth among all cancers worldwide. While screening has the potential to detect early cases of BC and reduce disease specific mortality, to date there are no routine screening programmes of asymptomatic individuals conducted anywhere in the world. There are however, a range of tests and procedures available for the detection and subsequent diagnosis of BC for select individuals presenting with urological symptoms and who are at increased risk of the disease.This chapter provides an overview of the traditional screening tools used for the detection of BC, such as urinalysis for haematuria and urinary cytology, as well as a brief description of follow-up procedures including cystoscopy, imaging, and treatment modalities.

Fractionated Urinary Cytology in the Follow-up of Bladder Cancer

1990 ◽  
Vol 66 (1) ◽  
pp. 40-41 ◽  
Author(s):  
K. J. HASTIE ◽  
R. AHMAD ◽  
C. U. MOISEY
Keyword(s):  
Bladder Cancer ◽  
Urinary Cytology

A modified ileal conduit technique in patients undergoing radical cystectomy: Single-centre experience

2021 ◽  
pp. 205141582110414
Author(s):  
Francesco Chiancone ◽  
Francesco Persico ◽  
Marco Fabiano ◽  
Maurizio Fedelini ◽  
Clemente Meccariello ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Intraoperative Complications ◽  
Perioperative Outcomes ◽  
Multivariate Logistic Regression Model ◽  
Increased Risk

Objective: We aimed to evaluate perioperative outcomes and complications of a modified technique of ileal conduit diversion. Methods: Forty-seven cases of radical cystectomy with modified ileal conduit diversion were performed at our institution from January 2015 to January 2020. After radical cystectomy, a segment of ileum was used to pack the conduit and was placed below the digestive anastomosis. Then, the mesentery window of the ileo-ileal anastomosis was sutured. The ureters were anastomosed on their native side on single loop ureteral stents. All procedures were performed by a single surgical team. Intra- and postoperative complications were classified and reported according to the Satava and Clavien–Dindo grading systems. Results: The mean age of population was 66.40±10.14 years, and 76.6% were male. Concomitant diabetes was found in 31.9% of patients. About three quarters of patients had T2G3 bladder cancer. Mean blood loss was 449.36±246.50 ml, and hospitalization was 10.32±5 days. With a mean follow-up of 17.36±12.63 months, the recurrence rate was 17%, and 14.9% of patients died of bladder cancer. Out of the 47 patients, three (4.3%) experienced intraoperative complications, while 15 (31.9%) had postoperative complications. Of these, only three patients experienced Clavien–Dindo complications ⩾grade 3. Multivariate logistic regression model showed that diabetes ( p=0.023) and higher blood loss ( p=0.010) were significantly associated with an increased risk of postoperative complications. We reported one case of ureterointestinal anastomosis stenosis on the left side and none on the right side. Despite our results being promising, larger randomized trials with longer follow-up are needed to explore further the feasibility of this technique on a larger scale. Conclusion: We describe a safe and simple surgical technique with a similar postoperative complications rate and a lower incidence of ureteroileal anastomosis stenosis compared to the standard technique. Level of evidence 4.

scholarly journals Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016538 ◽  
Author(s):  
Kishor Hadkhale ◽  
Jill MacLeod ◽  
Paul A Demers ◽  
Jan Ivar Martinsen ◽  
Elisabete Weiderpass ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Nordic Countries ◽  
Occupational Cancer ◽  
Occupational Groups ◽  
Cancer Study ◽  
Increased Risk ◽  
Occupational Patterns ◽  
Tobacco Workers ◽  
Reduced Risk

ObjectivesThe objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada.MethodsIn the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC.ResultsElevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort.ConclusionWe observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation.

Bladder Cancer to Patients Younger than 30 Years: A Retrospective Study and Review of the Literature

2017 ◽  
Vol 84 (4) ◽  
pp. 231-235 ◽  
Author(s):  
Ioannis Katafigiotis ◽  
Stavros Sfoungaristos ◽  
Alberto Martini ◽  
Konstantinos Stravodimos ◽  
Ioannis Anastasiou ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Risk Factor ◽  
Retrospective Study ◽  
Radical Cystectomy ◽  
Young Patients ◽  
Multimodality Treatment ◽  
Urinary Cytology ◽  
Macroscopic Hematuria ◽  
Multiple Recurrences

Objectives The aim of this report was to study the specific characteristics of bladder cancer in patients younger than 30 years. Materials and Methods Five patients with a mean age of 24 ± 2.83 years were included in the study. All patients had painless macroscopic hematuria as the first symptom. Three patients had pTa as a first diagnosis, one had pT1 and one pT2. All the patients had smoking as a risk factor and at least one additional possible risk factor. Results One patient with pTa had an aggressive course and after multiple recurrences was diagnosed with pT2 and refused to be submitted to radical cystectomy and died from the disease even though he received a multimodality treatment. The other two patients with the pTa diagnosis had no recurrence after the first TUR-BT and the patient with the pT1 diagnosis after one recurrence with a pTa histology is free of recurrence for the last 2 years. The patient diagnosed with pT2 was submitted to a radical cystectomy and an s-pouch diversion with a preservation of the genital system in order to have the ability of a future motherhood with the acceptance of course risks. Conclusions Young patients with bladder cancer is a difficult group of patients and show more reluctance to comply to the necessary strict follow-up of the repeated urinary cytology examinations, cystoscopies and CT pyelographies. Herein, we report a retrospective study of five patients younger than 30 years with bladder cancer.

scholarly journals Incidence and outcome of salvage cystectomy after bladder sparing therapy for muscle invasive bladder cancer: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Victor M. Schuettfort ◽  
Benjamin Pradere ◽  
Fahad Quhal ◽  
Hadi Mostafaei ◽  
Ekaterina Laukhtina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bladder Cancer ◽  
Meta Analysis ◽  
Invasive Bladder Cancer ◽  
Treatment Modalities ◽  
Complication Rates ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
Bladder Sparing

Abstract Objective We conducted a systematic review and meta-analysis to assess the available literature regarding the surgical and oncologic outcomes of patients undergoing salvage radical cystectomy (SV-RC) for recurrence or failure of bladder sparing therapy (BST) for muscle-invasive bladder cancer (MIBC). Methods We searched MEDLINE (PubMed), EMBASE and Google Scholar databases in May 2020. We included all studies of patients with ≥ cT2N0/xM0 bladder cancer that were eligible for all treatment modalities at the time of treatment decision who underwent BST including radiotherapy (RTX). A meta-analysis was conducted to calculate the pooled rate of several variables associated with an increased need for SV-RC. Study quality and risk of bias were assessed using MINORS criteria. Results 73 studies comprising 9110 patients were eligible for the meta-analysis. Weighted mean follow-up time was 61.1 months (range 12–144). The pooled rate of non-response to BST and local recurrence after BST, the two primary reasons for SV-RC, was 15.5% and 28.7%, respectively. The pooled rate of SV-RC was 19.2% for studies with a follow-up longer than 5 years. Only three studies provided a thorough report of complication rates after SV-RC. The overall complication rate ranged between 67 and 72% with a 30-day mortality rate of 0–8.8%. The pooled rates of 5 and 10-year disease-free survival after SV-RC were 54.3% and 45.6%, respectively. Conclusion Approximately one-fifth of patients treated with BST with a curative intent eventually require SV-RC. This procedure carries a proportionally high rate of complications and is usually accompanied by an incontinent urinary diversion.

Second cancer risk 40 years after cure for Hodgkin lymphoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8039-8039
Author(s):  
Michael Schaapveld ◽  
Berthe M Aleman ◽  
Anja M Eggermond ◽  
Cecile P Janus ◽  
Augustinus Krol ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Risk ◽  
Hodgkin Lymphoma ◽  
Hazard Ratio ◽  
Treatment Modalities ◽  
Second Cancer ◽  
Radiation Fields ◽  
Increased Risk ◽  
The Impact

8039 Background: During the last decades Hodgkin Lymphoma (HL) treatment changed towards less toxic chemotherapy schemes and smaller radiation fields. The impact of these changes on second cancer (SC) risk is still unknown. Methods: We calculated standardized incidence ratios (SIR), comparing SC risk after HL treatment with expected risk, based on cancer incidence in the general population, and compared SC risk between treatment modalities, accounting for competing events, in a large Dutch cohort comprising 3,390 5-years HL survivors, aged 15-51 years at HL treatment and diagnosed between 1965-2000. Results: The median follow-up was 18.2 years; 23% of the patients was followed ≥25 years. During follow-up 734 SCs and 92 third cancers (TC) occurred. The SIR for any SC was 4.5 (95% confidence interval (95%CI) 4.1-4.9). SC risk was still elevated after 35 years of follow-up (SIR 3.9; 95%CI 2.5-5.8) and cumulative incidence (CI) reached 47.1% (95%CI 43.6-50.5) at 40 years follow-up. For TCs the SIR was 5.5 (95%CI 4.4-6.9); the 20-year CI was 22.3% (95%CI 17.8-27.2). Risks of NHL and leukemia strongly decreased in more recent treatment periods (P-trend <0.001). The CI of solid tumors (ST) between 5-19 years after HL treatment did not differ for patients treated between 1965-1979, 1980-1989 or 1990-2000 (P=0.21; 19-year CI 9.1%, 11.6% and 11.4%, respectively). Radiotherapy (RT) above the diaphragm increased risk of STs above the diaphragm (hazard ratio (HR) 2.4, P<0.001), while subdiaphragmatic RT was associated with a 1.7-fold increased HR of a subdiaphragmatic ST (P=0.001). An incomplete mantle field was associated with significantly lower breast cancer (BC) risk (hazard ratio (HR) 0.4, 95%CI 0.2-0.8). A cumulative procarbazine dose >4.2 g/m2 yielded a 1.3-fold increased HR (95%CI 1.0-1.7) for non-breast STs and a 2-fold (95%CI 1.2-3.1) increased HR for gastrointestinal STs, but was associated with a strongly decreased BC risk (HR 0.3, 95%CI 0.2-0.6). Conclusions: SC risk after HL has decreased with treatment changes over the last decades, due to strongly decreasing risk of leukemia and NHL. Smaller radiation fields and procarbazine doses >4.2 g/m2 are associated with lower breast cancer risk, while high procarbazine doses increase risk of gastrointestinal STs.

Risk of depression following prostate cancer work-up: A nationwide study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5061-5061
Author(s):  
Anne Sofie Friberg ◽  
Klaus Brasso ◽  
Elisabeth Wreford Andersen ◽  
Signe Benzon Larsen ◽  
John Thomas Helgstrand ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cumulative Incidence ◽  
Treatment Modalities ◽  
Income Quintile ◽  
Increased Risk ◽  
Diagnostic Work ◽  
The Impact ◽  
Work Up ◽  
Diagnostic Work Up

5061 Background: Little is known about the psychological impact of undergoing evaluation for prostate cancer (PCa). We investigated the risk of developing a depression following PCa work-up with benign and malignant findings, respectively, compared with cancer-free men. Methods: A nationwide cohort of men who underwent prostate needle biopsies in Denmark from 1997–2011 was identified through the Danish Prostate Cancer Registry. Primary outcome was indication of moderate to severe depression defined as hospital contact for depression or first redemption of a prescribed antidepressant. For comparison, we selected a minimum of five age-matched cancer-free men per man who had undergone PCa specific diagnostic work-up. We excluded men with other cancer, major psychiatric disorder or use of antidepressants up to three years before study entry. Information on outcome and covariates (age, period, cohabitation status, income quintile and comorbidity) were retrieved from National Danish registries. We illustrated the risk of depression by cumulative incidence functions. Data were analyzed using Cox models adjusted for possible confounders. Results: We identified 54,766 men who underwent work-up including transrectal biopsies of the prostate, among these, 21,419 biopsy sets were benign and 33,347 men were diagnosed with PCa. We found an increasing cumulative incidence of depression in all groups. However, men diagnosed with PCa had a significantly higher risk throughout up to 18 years of follow-up. The adjusted hazard ratio (HR) of depression in men diagnosed with PCa was increased throughout follow-up with the highest risk in the two years following diagnosis (HR 2.77, 95% CI 2.66–2.87). After undergoing biopsies, men with benign results had an increased risk of depression (HR 1.22, 95% CI 1.14–1.31) in the first two years compared with cancer-free men; hereafter, we found no difference. Conclusions: We found an increased risk of depression in men following diagnostic work-up for PCa compared with a matched background population. In men diagnosed with PCa, the risk remained increased throughout the study period. Future studies are needed to further analyze the impact of stage and treatment modalities.

Predictive Validity of Health-Related Fitness Tests on Back Pain and Related Disability: A 6-Year Follow-Up Study Among High-Functioning Older Adults

2012 ◽  
Vol 9 (2) ◽  
pp. 249-258 ◽  
Author(s):  
Pauliina Husu ◽  
Jaana Suni
Keyword(s):  
Older Adults ◽  
Back Pain ◽  
Community Dwelling ◽  
Screening Tools ◽  
Increased Risk ◽  
Fitness Tests ◽  
Health Related ◽  
Side Bending ◽  
Health Related Fitness

Background:Back pain and related disability seem to be increasing among older adults. Health-related fitness tests have been developed to identify individuals at risk for mobility difficulties. However, poor fitness as a risk factor for back problems has seldom been studied. The purpose of the current study was to investigate whether performance in fitness tests predicts back pain and related disability during 6 years of follow-up.Methods:Study population consisted of community-dwelling men and women, born 1927 to 1941, who participated in assessment of health-related fitness and reported no long-term back pain or related disability at baseline (n = 517). The assessment included measurements of body mass index (BMI), one-leg stand, backward tandem walk, trunk side-bending, dynamic back extension, forward squat, 6.1-m walking speed and 1-km walk time.Results:Prospective analyses indicated that poor fitness (poorest-third) in one-leg stand and trunk side-bending tests were the most powerful predictors of back pain. Regarding disability, poor fitness in dynamic back extension and overweight in terms of BMI ≥ 27 increased the risk.Conclusions:Tests of balance, trunk flexibility and trunk muscle endurance, as well as BMI can be implemented as screening tools for identifying persons with increased risk of back pain and related disability.

Flow Cytometry Analysis in Voided Urine of Patients with Bladder Cancer

1993 ◽  
Vol 60 (2) ◽  
pp. 162-166
Author(s):  
A. Lotto ◽  
G. Carluccio ◽  
A. Calisti ◽  
A. Disperati ◽  
E. Capuzzo ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Bladder Cancer ◽  
Quantitative Evaluation ◽  
Dna Content ◽  
Urine Cytology ◽  
Urinary Cytology ◽  
Flow Cytometry Analysis ◽  
Excellent Correlation ◽  
First Diagnosis

Flow cytometry is known to be able to give a quantitative evaluation of the DNA of cellular populations (grade of ploidy), as well as to estimate the percentages of phases (S + G2M) providing useful information about the pathology in question and its aggressivity. This method has been applied in diagnosing patients with bladder cancer, using their voided urine and comparing with urine cytology. Our data, from 59 patients, indicate flow cytometry utility in diagnosing bladder cancer; in fact there is an excellent correlation between the urinary cytology and the DNA content in cytometry which increases in higher grade bladder cancer. The sensitivity of CFM is in the range of 92% to 94%, and is superior to that of conventional voided urine cytology (range 64% to 84%). It is felt that cytofluorometric analysis permits a reliable evaluation of voided urine, not only at first diagnosis, but especially during follow-up.

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