Screening High Risk Patients for Bladder Cancer is Cost-effective

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Yair Lotan, M.D., urologist at the University of Texas, Southwestern Medical Center at Dallas, presented new data regarding the cost-effectiveness and the lives saced from screening versus not screening for bladder cancer.

This study was presented during a May 22 Bladder Cancer Detection and Screening podium presentation at the annual meeting of the American Urological Association held in Atlanta.

Dr. Lotan and his colleagues also looked at the factors that limit the effectiveness of cancer screening, including survival benefit, disease prevalence, screening efficacy and costs.

The Marcov decision analysis model was created to estimate cumulative cancer-related costs and efficacy of screening (versus not screening) a high risk population for bladder cancer using a urine-based tumor marker (such as the NMP22 Bladder Chek Test) over a five-year period. High riask was designated as over 50 years of age with heavy smoking history or significantl occupational exposure to toxins and dyes.

“While the goal of cancer screening is to detect cancer early and save lives, it must be reasonably cost-effective if it is to be instituted widely,” said Dr. Lotan.

The researchers at the University of Texas developed a bladder cancer screening model that projected a gain of three life years and $101.000 saved per 1000 people screened based o­n a poputation with 4% incidence of bladder cancer.

Researchers noted that adjusting for other causes of mortality did not vary the results significantly, and screening versus not screening is more cost-effective as long as the cancer incidence is greater than 1,6%.

Nationally, bladder cancer has the highest cost per patient of all cancers from diagnosis to death. This cancer has more than 63.000 new cases a year and is the 5th most common cancer among men and women in the United States. This year alone in the U.S. it’s estimated that bladder cancer will cost $4 billion in direct costs.

“The best possibility for reducing bladder cancer mortality is early detection,” said Dr. Lotan. ” o­ne out of four bladder malignancies are currently diagnosed at an advanced stage.”

Bladder tumors detected early at a non muscle invasive stage are very treatment, and the five-year survival rate is 95%. However o­nce the tumors become more advanced the survival rate drops steadily from 50% to 10%.

This study goes beyond analyzing the cost of cancer detected. This study is about the cost per life saved and defines how effective a urine marker needs to be perform as a screening tool. o­nce detected, bladder cancer has o­ne of the highest rates of recurrence of all cancers.

“From a surveillance standpoint, it may be advantageous to monitor bladder cancer using a cost-effective yet highly sensitive urine marker test,” said Dr. Lotan. “

With the FDA approval of the NMP22 Test for diagnosing high risk patients, the healthcare community has an initial test that can be assessed for efficacy in screening.”

Compared to breast, prostate, and cervical cancer screening, bladder cancer screening is in its infancy. Dr. Lotan hopes this model will help healthcare professionals identify at risk populations that would benefit from bladder cancer Screening.

Written by Lloyd Gomez