Bladder Cancer Screening Trial
Optimal Screening Strategy for Bladder Cancer in at Risk Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Bladder cancer is the 4th most common cancer in men and 6th most common cancer overall with over 80,000 new cases in the US per year. The most common causes of bladder cancer are smoking and it is usually found in patients over the age of 50. By the time it is diagnosed, the disease is often advanced since there are few warning signs other than seeing blood in the urine.
Screening is currently accepted practice for colon, cervical, and breast cancer. However, there is not an accepted screening methodology for bladder cancer. Bladder cancer is currently detected in 2-5% of patients who have microhematuria on routine urinalysis, a cheap, non-invasive test obtained by many primary care physicians. Bladder cancer diagnosed by microscopic blood on urinalysis is often lower stage than patients diagnosed with visible blood. Urine testing, therefore, offers a simple screening mechanism that can be tailored to patients at higher risk for bladder cancer based on age, tobacco exposure and other risk factors. In conjunction with routine traditional urinalysis testing, there are advances in urine molecular markers which utilize protein and genetic alterations resulting in a higher sensitivity and specificity for the detection of bladder cancer. Markers have not been evaluated for screening in high-risk populations, and there is a gap in knowledge of the most accurate screening method.
Early detection of bladder cancer has the potential to identify disease at an earlier stage resulting in a lower burden of treatment, improved quality of life, and improved survival.
This study will prospectively screen patients at high risk for the development of bladder cancer at bi-annual intervals with a commonly available urinalysis test that assess for microhematuria and urine based molecular markers.
This is a single arm study. The outcomes from the experimental arm will be compared to a historical control (bladder cancer detected by standard of care using SEER registries).
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Yair Lotan, MD
- Phone Number: 214-648-0389
- Email: yair.lotan@UTsouthwestern.edu
Study Locations
-
-
Texas
-
Dallas, Texas, United States, 75390
- Recruiting
- University of Texas Southwestern Medical Center
-
Principal Investigator:
- Yair Lotan, MD
-
Contact:
- Sonobia Garrett
- Phone Number: 214-645-8787
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 50
- Smoking: ≥15 pack-year smoking history
- Occupation:≥ 15 years of occupational exposures including: textile worker, painter, dry cleaners
Exclusion Criteria:
- Prior history of bladder, kidney, or prostate cancer
- Prior evaluation of micro or gross hematuria within the last 2 years
- Do not provide informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: Historical Control Group
This will include historical control (bladder cancer detected in patients by standard of care) using SEER registries).
|
|
|
Experimental: BCa Early Screening Group
All participants undergo Urinalysis testing every 6 months for 2 years. Based on the RBC count, each participant will go through each of the screening procedures : [cystoscopy + Upper tract imaging] or [urine marker cancer testing with Cxbladder triage + Upper tract imaging] or [Repeat urinalysis] Patients with suspicious findings on cystoscopy or imaging will get treatment as per standard of care. Their outcomes will be compared to a historical control (bladder cancer detected by standard of care using SEER registries). |
Urine analysis (every 6 months for 2 years); Patients with <3 red blood cells (RBCs) per high-powered field (HPF) will repeat screening at 6-month intervals for an average of 2 years. If RBCs are 3-25 RBSc/HPF- subjects will undergo- [cystoscopy + Upper tract imaging] or [urine marker cancer testing with Cxbladder triage + Upper tract imaging]. If >25 RBCs, subjects will get - [cystoscopy + Upper tract imaging]. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Incidence of Bladder cancer (BCa)
Time Frame: 5 years
|
Incidence of Bladder cancer is measured by the number of participants who were detected with BCa.
|
5 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Smoking cessation
Time Frame: 3 years
|
Smoking cessation is measured by number of participants who were referred to smoking cessation treatment
|
3 years
|
|
Screening interval
Time Frame: approx. every 6 months for up to 2 years
|
Screening interval is assessed by calculating the average screening interval from baseline until the timepoint when RBCs >3 are detected for each participant
|
approx. every 6 months for up to 2 years
|
|
Screening interval
Time Frame: approx. every 12 months for up to 2 years
|
Screening interval is assessed by calculating the average screening interval from baseline until the timepoint when RBCs >3 are detected for each participant
|
approx. every 12 months for up to 2 years
|
|
Number of participants with positive/ negative markers and findings on cystoscopy
Time Frame: 2 years
|
Performance of urinalysis and molecular markers is assessed by the count of participants with positive/ negative markers and findings on cystoscopy
|
2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Yair Lotan, MD, University of Texas Southwestern Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Pathologic Processes
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Male Urogenital Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urination Disorders
- Neoplasms by Histologic Type
- Hemorrhage
- Neoplasms, Glandular and Epithelial
- Urologic Neoplasms
- Carcinoma
- Urinary Bladder Diseases
- Pathological Conditions, Signs and Symptoms
- Behavior
- Health Behavior
- Urinary Bladder Neoplasms
- Carcinoma, Transitional Cell
- Hematuria
- Smoking Cessation
- Investigative Techniques
- Clinical Laboratory Techniques
- Diagnostic Techniques and Procedures
- Diagnosis
- Diagnostic Techniques, Urological
- Clinical Chemistry Tests
- Urinalysis
Other Study ID Numbers
Other Study ID Numbers
- STU-2022-1042
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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