Authors' objectives:

To provide a review of the evidence on screening for bladder cancer.

Authors' results and conclusions: We found no high-quality direct evidence addressing the effectiveness of screening for bladder cancer on morbidity or mortality from that disease. We found no studies on the accuracy and reliability of screening tests for bladder cancer that allow us to accurately determine the sensitivity or specificity of screening in the general primary care population. We found no high-quality trials that compared health outcomes in treated and untreated groups with the type of bladder cancer that would be detected by screening.

Authors' recommendations: The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for bladder cancer in adults. The USPSTF found fair evidence that screening with available tests can detect bladder cancer in asymptomatic individuals. The potential benefit of screening would be small, at best, for the following reasons: there is fair evidence that many of the cancers detected by screening have a low tendency to progress to invasive disease; there is a relatively low overall prevalence of asymptomatic bladder cancer that would eventually lead to important clinical consequences; and there is limited evidence that early treatment of bladder cancer detected through screening improves long-term health outcomes. The potential harms of screening are at least small: screening tests have a low positive predictive value and yield many false positive results, leading to unnecessary invasive procedures. As a result, the USPSTF concluded that the potential harms of screening for bladder cancer outweigh any potential benefits.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/uspstf/uspsblad.htm

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)