Novel urinary tumor markers for bladder cancer may permit early detection and improved oncologic outcomes, but data regarding their utilization is limited. We sought to identify trends in utilization of urinary markers and long-term outcomes of urinary tumor marker use in patients with bladder cancer.
Data from the Surveillance, Epidemiology, and End Results-Medicare (SEER-Medicare) database from 2001 to 2011 were used to identify a cohort of 64,450 patients with bladder cancer who underwent urinary marker testing (UMT) with UroVysion FISH, NMP22, or the BTA Stat tests. Prevalence of UMT and urine cytology use were assessed. Characteristics of patients who did and did not undergo UMT were analyzed using chi-square. Predictors of UMT were analyzed using a multivariable logistic regression model, and Cox proportional hazards were used to determine unadjusted cancer-specific and overall mortality risks.
UMT increased from 17.8% to a peak of 28.2% during the years studied (p<0.0001). Predictors of marker use included female gender, younger age, and lower Charlson score. Overall and cancer specific survival improved on Kaplan-Meier and Cox proportional hazards analyses with urinary marker testing.
Increased use of UMT was documented over all stages and grades of bladder cancer, and in certain patient/provider variables. This increase may have contributed to improved overall and cancer specific survival. Additional investigation is necessary to further characterize this benefit.
The Journal of urology. 2017 Aug 28 [Epub ahead of print]
Vikram M Narayan, Oluwakayode Adejoro, Ian Schwartz, Matthew Ziegelmann, Sean Elliott, Badrinath R Konety
University of Minnesota, Department of Urology, Minneapolis, MN., University of Minnesota, Department of Urology, Minneapolis, MN. Electronic address: .