Advances in screening protocols for the detection of early bladder cancer.
Bladder cancer screening faces several obstacles, including low yield, numerous false-positive results, and the absence of a single effective screening test. We present a model of a screening program that (1) targets an occupational cohort exposed to a putative carcinogen, to increase the detection of disease, (2) uses four screening tests in parallel to maximize case detection, and (3) defines a diagnostic protocol that minimizes the number of invasive procedures by utilizing both flexible and rigid cystoscopy. In a hypothetical cohort of 1000 men aged 45 to 74 years potentially exposed to a bladder carcinogen, the model would find eight of the nine detectable cancers, with a sensitivity of 89% and a specificity of 78%. In addition, the model allows the sensitivities, specificities, and predictive values of the individual screening tests to be compared and evaluated in a single cohort.
Geller
A C
AC
Boston University School of Public Health, MA 02118.
Brooks
D R
DR
Barber
C E
CE
Koh
H K
HK
Lew
R A
RA
Wax
S
S
Prout
M N
MN
D000368:Aged; D002985:Clinical Protocols; D003558:Cystoscopy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000517:prevention & control; D011933:Reagent Kits, Diagnostic; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced / Q000175:diagnosis* / Q000517:prevention & control; D014567:Urography
D011933:Reagent Kits, Diagnostic