Bladder cancer is the second most common malignancy of the genitourinary tract and fifth most common malignancy overall in the United States.1 The current standard for diagnosis and surveillance of bladder cancer includes a combination of cystoscopy and urine cytology.2 The propensity of bladder cancer for recurrence leads to a need for frequent monitoring, making bladder cancer currently the most expensive per-patient malignancy to treat in the United States.3
These points, along with the discomfort, anxiety, and morbidity of frequent cystoscopy have led to much effort in developing alternative, less-invasive methods for bladder surveillance.4 In this commentary, we suggest that no advancement in noninvasive testing has occurred in recent years capable of altering the current endoscopic surveillance scheme. We further argue that the poor performance, marginal clinical utility, and potential harm of the currently available urine tests make them inadequate for regular clinical use.
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