Screening adults for bladder cancer: A review of the evidence for the U.S. Preventive Services Task Force

Roger Chou, Tracy Dana

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: Bladder cancer is 1 of the 10 most frequently diagnosed types of cancer. Screening could identify high-grade bladder cancer at earlier stages, when it may be more easily and effectively treated. Purpose: To update the 2004 U.S. Preventive Services Task Force evidence review on screening for bladder cancer in adults in primary care settings. Data Sources: MEDLINE (2002 to December 2009), the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (through the fourth quarter of 2009), and the CancerLit subsection of PubMed (through March 2010) were searched for studies published in English. Study Selection: Randomized trials and controlled observational studies that directly evaluated screening for bladder cancer in adults, studies on the diagnostic accuracy of screening tests for bladder cancer, and randomized trials and controlled observational studies on clinical outcomes associated with treatment compared with no treatment of screen-detected or superficial bladder cancer. Data Extraction: Details were abstracted about the patient sample, study design, data analysis, follow-up, and results. Quality was assessed by using methods developed by the U.S. Preventive Services Task Force. Data Synthesis: No randomized trials or high-quality controlled observational studies evaluated clinical outcomes associated with screening compared with no screening or treatment of screen-detected bladder cancer compared with no treatment. No study evaluated the sensitivity or specificity of tests for hematuria, urinary cytology, or other urinary biomarkers for bladder cancer in asymptomatic persons without a history of bladder cancer. The positive predictive value of screening is less than 10% in asymptomatic persons, including higher-risk populations. No study evaluated harms associated with treatment of screen-detected bladder cancer compared with no treatment. Limitation: High-quality evidence was not available for any of the key questions. Conclusion: Additional research is needed to determine whether screening of adults for bladder cancer leads to better outcomes compared with no screening. Primary Funding Source: Agency for Healthcare Research and Quality.

Original languageEnglish (US)
Pages (from-to)461-468
Number of pages8
JournalAnnals of Internal Medicine
Volume153
Issue number7
StatePublished - Oct 5 2010

Fingerprint

Advisory Committees
Urinary Bladder Neoplasms
Observational Studies
Therapeutics
Randomized Controlled Trials
Information Storage and Retrieval
Health Services Research
Hematuria
PubMed
MEDLINE
Cell Biology
Primary Health Care
Biomarkers
Databases
Sensitivity and Specificity

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Screening adults for bladder cancer : A review of the evidence for the U.S. Preventive Services Task Force. / Chou, Roger; Dana, Tracy.

In: Annals of Internal Medicine, Vol. 153, No. 7, 05.10.2010, p. 461-468.

Research output: Contribution to journalArticle

@article{453e9858b80847b08029c6438671f8ca,
title = "Screening adults for bladder cancer: A review of the evidence for the U.S. Preventive Services Task Force",
abstract = "Background: Bladder cancer is 1 of the 10 most frequently diagnosed types of cancer. Screening could identify high-grade bladder cancer at earlier stages, when it may be more easily and effectively treated. Purpose: To update the 2004 U.S. Preventive Services Task Force evidence review on screening for bladder cancer in adults in primary care settings. Data Sources: MEDLINE (2002 to December 2009), the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (through the fourth quarter of 2009), and the CancerLit subsection of PubMed (through March 2010) were searched for studies published in English. Study Selection: Randomized trials and controlled observational studies that directly evaluated screening for bladder cancer in adults, studies on the diagnostic accuracy of screening tests for bladder cancer, and randomized trials and controlled observational studies on clinical outcomes associated with treatment compared with no treatment of screen-detected or superficial bladder cancer. Data Extraction: Details were abstracted about the patient sample, study design, data analysis, follow-up, and results. Quality was assessed by using methods developed by the U.S. Preventive Services Task Force. Data Synthesis: No randomized trials or high-quality controlled observational studies evaluated clinical outcomes associated with screening compared with no screening or treatment of screen-detected bladder cancer compared with no treatment. No study evaluated the sensitivity or specificity of tests for hematuria, urinary cytology, or other urinary biomarkers for bladder cancer in asymptomatic persons without a history of bladder cancer. The positive predictive value of screening is less than 10{\%} in asymptomatic persons, including higher-risk populations. No study evaluated harms associated with treatment of screen-detected bladder cancer compared with no treatment. Limitation: High-quality evidence was not available for any of the key questions. Conclusion: Additional research is needed to determine whether screening of adults for bladder cancer leads to better outcomes compared with no screening. Primary Funding Source: Agency for Healthcare Research and Quality.",
author = "Roger Chou and Tracy Dana",
year = "2010",
month = "10",
day = "5",
language = "English (US)",
volume = "153",
pages = "461--468",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "7",

}

TY - JOUR

T1 - Screening adults for bladder cancer

T2 - A review of the evidence for the U.S. Preventive Services Task Force

AU - Chou, Roger

AU - Dana, Tracy

PY - 2010/10/5

Y1 - 2010/10/5

N2 - Background: Bladder cancer is 1 of the 10 most frequently diagnosed types of cancer. Screening could identify high-grade bladder cancer at earlier stages, when it may be more easily and effectively treated. Purpose: To update the 2004 U.S. Preventive Services Task Force evidence review on screening for bladder cancer in adults in primary care settings. Data Sources: MEDLINE (2002 to December 2009), the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (through the fourth quarter of 2009), and the CancerLit subsection of PubMed (through March 2010) were searched for studies published in English. Study Selection: Randomized trials and controlled observational studies that directly evaluated screening for bladder cancer in adults, studies on the diagnostic accuracy of screening tests for bladder cancer, and randomized trials and controlled observational studies on clinical outcomes associated with treatment compared with no treatment of screen-detected or superficial bladder cancer. Data Extraction: Details were abstracted about the patient sample, study design, data analysis, follow-up, and results. Quality was assessed by using methods developed by the U.S. Preventive Services Task Force. Data Synthesis: No randomized trials or high-quality controlled observational studies evaluated clinical outcomes associated with screening compared with no screening or treatment of screen-detected bladder cancer compared with no treatment. No study evaluated the sensitivity or specificity of tests for hematuria, urinary cytology, or other urinary biomarkers for bladder cancer in asymptomatic persons without a history of bladder cancer. The positive predictive value of screening is less than 10% in asymptomatic persons, including higher-risk populations. No study evaluated harms associated with treatment of screen-detected bladder cancer compared with no treatment. Limitation: High-quality evidence was not available for any of the key questions. Conclusion: Additional research is needed to determine whether screening of adults for bladder cancer leads to better outcomes compared with no screening. Primary Funding Source: Agency for Healthcare Research and Quality.

AB - Background: Bladder cancer is 1 of the 10 most frequently diagnosed types of cancer. Screening could identify high-grade bladder cancer at earlier stages, when it may be more easily and effectively treated. Purpose: To update the 2004 U.S. Preventive Services Task Force evidence review on screening for bladder cancer in adults in primary care settings. Data Sources: MEDLINE (2002 to December 2009), the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials (through the fourth quarter of 2009), and the CancerLit subsection of PubMed (through March 2010) were searched for studies published in English. Study Selection: Randomized trials and controlled observational studies that directly evaluated screening for bladder cancer in adults, studies on the diagnostic accuracy of screening tests for bladder cancer, and randomized trials and controlled observational studies on clinical outcomes associated with treatment compared with no treatment of screen-detected or superficial bladder cancer. Data Extraction: Details were abstracted about the patient sample, study design, data analysis, follow-up, and results. Quality was assessed by using methods developed by the U.S. Preventive Services Task Force. Data Synthesis: No randomized trials or high-quality controlled observational studies evaluated clinical outcomes associated with screening compared with no screening or treatment of screen-detected bladder cancer compared with no treatment. No study evaluated the sensitivity or specificity of tests for hematuria, urinary cytology, or other urinary biomarkers for bladder cancer in asymptomatic persons without a history of bladder cancer. The positive predictive value of screening is less than 10% in asymptomatic persons, including higher-risk populations. No study evaluated harms associated with treatment of screen-detected bladder cancer compared with no treatment. Limitation: High-quality evidence was not available for any of the key questions. Conclusion: Additional research is needed to determine whether screening of adults for bladder cancer leads to better outcomes compared with no screening. Primary Funding Source: Agency for Healthcare Research and Quality.

UR - http://www.scopus.com/inward/record.url?scp=78349283393&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78349283393&partnerID=8YFLogxK

M3 - Article

C2 - 20921545

AN - SCOPUS:78349283393

VL - 153

SP - 461

EP - 468

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 7

ER -