Bladder cancer is a serious disease that can be life-threatening if not detected and treated early. It is the 10th most common cancer worldwide and the fourth most prevalent among men. Early detection of bladder cancer can improve clinical outcomes and survival rates, similar to other cancers. In recent years, researchers have been exploring ways to detect bladder cancer early and identify people who may be at higher risk. One 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 presented at the European Association of Urology (EAU) annual Congress showed that a urine test could be used to detect 10 specific genes that could help predict bladder cancer. The study found that gene mutations could be detected using urine samples and could be used to predict bladder cancer up to 12 years before diagnosis effectively. Researchers utilized urine samples to look at specific gene mutations. They 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.

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, emphasized that bladder cancer 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. Thus, early detection and diagnosis are critical components of effective treatment.

The study had 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 investigation. However, the study opens up the possibility of early detection and prediction of bladder cancer, hopefully increasing the chances of early intervention and treatment.

Non-study author Dr. Linehan explained that this study is vital if we can identify more targeted mutations in urine and provide more comprehensive testing, which can aid in bladder cancer identification—the urine tests we have only evaluated for a select number of genetic mutations. Adding more targets could potentially identify more cancers earlier, saving patients from invasive treatment.

Although further, more extensive studies will be needed, this study provides a critical genetic advance in understanding how bladder cancer develops. Impressively, 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. The test was more accurate than its comparison test, and it accurately predicted a lack of bladder cancer in controls 96% of the time.

Dr. Michael Johnson, a Washington University urologist at Siteman Cancer Center, explained the usefulness of looking into this subset of mutations. He stated that the researchers took urine samples from patients with bladder cancer and controls and performed genomic profiling. They analyzed 60 genes for mutations, ultimately finding the ten most predictive genes. A smaller set may be advantageous so they can do the test faster/cheaper.