Bladder cancer is the fourth most commonly diagnosed
cancer in men and the eighth most common
cancer in women in the USA. Efforts to reduce mortality from
bladder cancer must focus on three areas: prevention, development of effective
therapies for muscle-invasive and metastatic disease, and early detection of potentially invasive lesions while they are still superficial and amenable to less morbid, but still effective, treatments. As more effective
therapies for metastatic
transitional cell carcinoma are not on the immediate horizon and preventive measures (except for smoking cessation) have been disappointing, if we are to reduce this disease's morbidity and mortality rates significantly, early detection strategies need to be improved and implemented. The goal of screening for any type of
cancer is to detect the disease in its early stages in order to increase the chances for cure or
prolongation of life (before micro or gross
metastases occur). Since all patients who die of
bladder cancer do so from
metastases and since almost all patients with
metastases have muscle-invading
cancers appearing as the first
bladder cancer event, diagnosing
cancers destined to become muscle invading before they actually are should reduce
bladder cancer mortality. This special report reviews the current state of
bladder cancer screening in the USA.