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Screening for Bladder Cancer

Clinical Summary of U.S. Preventive Services Task Force Recommendation

Release Date: August 2011


This document is a summary of the 2011 recommendation of the U.S. Preventive Services Task Force on Screening for Bladder Cancer. It is intended for use by primary care clinicians. This summary was first published in Annals of Internal Medicine (Ann Intern Med 2011;155:247).


Population Asymptomatic adults
Recommendation No recommendation

Grade: I (Insufficient Evidence)

Risk Assessment Risk factors for bladder cancer include:
  • Smoking
  • Occupational exposure to carcinogens (e.g., rubber, chemical, and leather industries)
  • Male sex
  • Older age
  • White race
  • Infections caused by certain bladder parasites
  • Family or personal history of bladder cancer
Screening Tests Screening tests for bladder cancer include:
  • Microscopic urinalysis for hematuria
  • Urine cytology
  • Urine biomarkers
Interventions The principal treatment for superficial bladder cancer is transurethral resection of the bladder tumor, which may be combined with adjuvant radiation therapy, chemotherapy, biologic therapies, or photodynamic therapies.

Radical cystectomy, often with adjuvant chemotherapy, is used in cases of surgically resectable invasive bladder cancer.

Balance of Harms and Benefits There is inadequate evidence that treatment of screen-detected bladder cancer leads to improved morbidity or mortality.

There is inadequate evidence on harms of screening for bladder cancer.

Suggestions for Practice In deciding whether to screen for bladder cancer, clinicians should consider the following:
  • Potential preventable burden: early detection of tumors with malignant potential could have an important impact on the mortality rate of bladder cancer.
  • Potential harms: false-positive results may lead to anxiety and unneeded evaluations, diagnostic-related harms from cystoscopy and biopsy, harms from labeling and unnecessary treatments, and overdiagnosis.
  • Current practice: screening tests used in primary practice include microscopic urinalysis for hematuria and urine cytology; urine biomarkers are not commonly used in part because of cost. Patients with positive findings are typically referred to a urologist for further evaluation.
Relevant USPSTF Recommendations Recommendations on screening for other types of cancer can be found at www.uspreventiveservicestaskforce.org.

For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.

Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

AHRQ Publication No. 11-05148-EF-4
Current as of August 2011

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Internet Citation:

Screening for Bladder Cancer: Clinical Summary of U.S. Preventive Services Task Force Recommendation. AHRQ Publication No. 11-05148-EF-4, August 2011. http://www.uspreventiveservicestaskforce.org/uspstf11/bladdercancer/bladcansum.htm


 


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