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Costly tests may not help detect bladder cancer recurrence, M. D. Anderson study finds
Date:3/3/2010

e wanted to identify which bladder surveillance method provides acceptable tumor detection rate while minimizing costs," said Karam.

Kamat and his colleagues prospectively evaluated 200 M. D. Anderson patients with NMIBC. They compared the accuracy and cost of cystoscopy alone and cystoscopy combined with:

  • Cytology, examining bladder cells with a microscope
  • NMP22, a urine test that tests the level of NMP22 protein
  • FISH (fluorescence in situ hybridization), a urine test for chromosomal aberrations in bladder cells
  • NMP22 confirmed by FISH

By looking at the number of tumors detected and the cost of the tests (based on Medicare 2009 data) plus the cost of work-up for a false positive result, researchers arrived at a cost per tumor detected for each method. Cystoscopy alone was the least expensive at $7,692, while cystoscopy plus FISH was the priciest at $19,111.

But despite their added costs, additional tests did not give better results. Cystoscopy was most cost effective in finding tumors. Cystoscopy had two false positives, the fewest of any test, while cystoscopy plus FISH had the most false positives at 30.

"There are some who believe that the ancillary tests have the property to predict recurrences early," Kamat said. "In order to account for this, we took into account tumors detected later - at the first follow-up - to assess whether the tests added to detection rates. Our results suggest that, while the ancillary tests did turn positive prior to actual tumor recurrence in a handful of patients, the vast majority were still falsely positive."

Kamat said he would like to see the findings of this study confirmed in the near future by a multi-center co-operative study.


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Contact: Laura Sussman
lsussman@mdanderson.org
713-745-2457
University of Texas M. D. Anderson Cancer Center
Source:Eurekalert  

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Costly tests may not help detect bladder cancer recurrence, M. D. Anderson study finds
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