Current perspectives of urine-based tests for screening and post-treatment monitoring of urothelial carcinoma of the bladder

Abstract

Patients and physicians have long preferred reducing the number of cystoscopies for hematuria screening and post-treatment monitoring. DNA alteration- and mRNA-based urinary tests have demonstrated high diagnostic accuracy for detecting UC, including low-grade tumors, as reported in previous studies. In the STRATA trial (5), researchers validated the clinical utility of CxbT in safely reducing unnecessary cystoscopies in low-risk patients with microhematuria. However, this study has limitations, including the absence of patient quality of life (QOL) assessment and economic impact analysis of CxbT in patients with microhematuria. Additionally, external validation using diverse cohorts is currently lacking. Further post-hoc analyses of the STRATA trial and prospective studies designed to confirm the high cost-effectiveness of these tests are needed to support their widespread adoption.