title: [Bladder cancer screening with urine-based tumour markers - occupational medical experience].
abstract: OBJECTIVE
  Bladder cancer responds favourably to treatment and has a good survival rate, provided it is diagnosed at an early stage. Established methods exist for the early detection, however, their specificity and positive predictive value are not yet satisfactory. Innovative markers have been proposed, but still require validation in prospective studies. We provide a literature-based short overview on the currently available and some proposed markers for the early detection of bladder cancer and evaluate the need for validation in further studies. We further provide some first results of such a recently finished study in an occupational setting.
  
  
  METHODS
  We conducted a prospective screening study over seven years in 1610 males with former occupational exposure to carcinogenic aromatic amines. Annual bladder cancer screening according to statutory requirements was offered. In addition to the regularly performed check for hematuria and urine cytology, the markers NMP22, UroVysion™ and survivin were performed in voided urine samples of the participants. Positive findings (not for survivin) were further followed through urethrocystoscopy.
  
  
  CONCLUSIONS
  A total of 7219 urine samples were screened. During the study period 16 incidental and 4 recurrent bladder tumours, thereof three papillomas, occurred in a total of 19 participants. 14 out of twenty tumours were marker-positive, and all but two were early stage findings. Cell-based markers (cytology, UroVysion™) und molecular markers (NMP22, survivin) were largely complementary, thus acting as a "multi-marker panel". Eight of the tumours were identified by a positive cytology. Six tumours were not detected by any of the tumour markers. The results will be further evaluated through the inclusion of confounding factors, which have so far rarely been examined in other studies. This may lead to the development of tiered diagnostic strategies with the aim to reduce the number of invasive diagnostic procedures in the future.
authors: BASF SE, Occupational Medicine & Health Protection, Ludwigshafen, Germany. michael.nasterlack@basf.com
authors: M
authors: M
authors: Nasterlack
authors: G
authors: G
authors: Feil
authors: G
authors: G
authors: Leng
authors: B
authors: B
authors: Pesch
authors: S
authors: S
authors: Huber
authors: K-D
authors: KD
authors: Sievert
authors: G
authors: G
authors: Johnen
authors: D
authors: D
authors: Taeger
authors: T
authors: T
authors: Mayer
authors: M
authors: M
authors: Kluckert
authors: T
authors: T
authors: Brüning
authors: A
authors: A
authors: Stenzl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000814:Aniline Compounds; D014408:Biomarkers, Tumor / Q000652:urine*; D055088:Early Detection of Cancer / Q000379:methods*; D006417:Hematuria / Q000139:chemically induced / Q000175:diagnosis / Q000652:urine; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D033162:Incidental Findings; D051034:Inhibitor of Apoptosis Proteins / Q000652:urine; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced / Q000175:diagnosis / Q000473:pathology / Q000652:urine; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000652:urine; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000652:urine*; D016273:Occupational Exposure; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D000077022:Survivin; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced / Q000175:diagnosis* / Q000473:pathology / Q000652:urine*; D014556:Urine / Q000166:cytology
chemical_list: D000814:Aniline Compounds; C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D009687:Nuclear Proteins; D000077022:Survivin; C100379:nuclear matrix protein 22