Screening for Bladder Cancer

For screening to be cost-effective a disease has to have sufficient prevalence and there need to be tests that can result in early detection and improved survival. While bladder cancer is the fourth most common cancer in men, overall the incidence of bladder cancer is too low to justify screening in the general population. Risk stratification based on known risk factors such as age, gender, smoking history, or occupational exposures may allow identification of a population with sufficient incidence of disease to justify screening. There will need to be optimization of testing for detection and evidence of improved survival from early diagnosis. There is potential for screening to detect disease prior to muscle invasion, which could result in a survival benefit. The cost implications of screening will also be important to consider. In this chapter we will review the epidemiology of bladder cancer and risk factors for the disease, highlight previous bladder cancer screening trials, and discuss cost issues associated with screening.