Screening for bladder cancer with urinary tumor markers in chemical workers with exposure to aromatic amines

Pesch, Beate; Taeger, Dirk; Johnen, Georg; Gawrych, Katarzyna; Bonberg, Nadine; Schwentner, Christian; Wellhäußer, Harald; Kluckert, Matthias; Leng, G.; Nasterlack, Michael; Lotan, Yair; Stenzl, Arnulf; Brüning, Thomas

doi:10.1007/s00420-013-0916-3

Cited by 57 publications

(46 citation statements)

References 30 publications

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“…In a sample of 1,609 men with former workplace exposure to aromatic amines, the UroVysion/NMP22 panel detected 14 of 21 tumors versus eight tumors with cytology alone. However, the increase in sensitivity compared with cytology was not balanced by the high costs of UroVysion and the false-positive tests of NMP22 [44]. Based on these results, it is not currently cost effective to apply these markers for screening in an asymptomatic population.…”

Section: Economic Evaluationsmentioning

confidence: 67%

The Health Economics of Bladder Cancer: An Updated Review of the Published Literature

2014

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The purpose of this paper is to provide a current view of the economic burden of bladder cancer, with a focus on the cost effectiveness of available interventions. This review updates a previous systematic review and includes 72 new papers published between 2000 and 2013. Bladder cancer continues to be one of the most common and expensive malignancies. The annual cost of bladder cancer in the USA during 2010 was $US4 billion and is expected to rise to $US5 billion by 2020. Ten years ago, urinary markers held the potential to lower treatment costs of bladder cancer. However, subsequent real-world experiments have demonstrated that further work is necessary to identify situations in which these technologies can be applied in a cost-effective manner. Adjunct cytology remains a part of diagnostic standard of care, but recent research suggests that it is not cost effective due to its low diagnostic yield. Analysis of intravesical chemotherapy after transurethral resection of bladder tumor (TURBT), neo-adjuvant therapy for cystectomy, and robot-assisted laparoscopic cystectomy suggests that these technologies are cost effective and should be implemented more widely for appropriate patients. The existing literature on the cost effectiveness of bladder cancer treatments has improved substantially since 2000. The body of work now includes many new models, registry analyses, and real-world studies. However, there is still a need for new implementation guidelines, new risk modeling tools, and a better understanding of the empirical burden of bladder cancer.

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Section: Economic Evaluationsmentioning

confidence: 67%

The Health Economics of Bladder Cancer: An Updated Review of the Published Literature

2014

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“…Subsequent to the compilation of these recommendations, a few new articles have been published [219]. Indeed, authors analysed the performance of FISH (Fluorescence In Situ Hybridisation) in combination with NMP22 for bladder cancer screening in this population.…”

Section: Discussionmentioning

confidence: 99%

Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement

Clin

Pairon

2014

BMC Public Health

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BackgroundThe aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to carcinogenic substances for the bladder.MethodsA critical synthesis of the literature was conducted. Sectors of activity where workers are or were exposed to carcinogenic substances for the bladder were listed and classified according to the level of bladder cancer risk. Performances of techniques available for the targeted screening of bladder cancer were analysed, including a simulation of results among high-risk populations in France.ResultsThe risk level for the professional group and the latency period between the start of exposure and the natural history of the disease were selected to define a targeted screening protocol. The NMP22BC test, exclusive haematuria testing, and combinations of urine cytology with, respectively, the NMP22BC test and haematuria test, generated an extremely high proportion of false positive results.ConclusionUrine cytology is the test that offers the best specificity. Although poor for all bladder cancer stages and grades combined, its sensitivity is better for high grades, which require early diagnosis since late-stage cancers are of very poor prognosis. These results suggest that urine cytology is currently the only technique suitable for proposal within the context of a first line targeted screening strategy for occupational bladder cancer. An algorithm summarising the recommended medical follow-up for workers currently or previously exposed to carcinogenic substances for the bladder is proposed, based on the level of risk of bladder cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-1155) contains supplementary material, which is available to authorized users.

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“…Being in a chemical company, a potential exposure to carcinogenic substances in the past (eg, aromatic amines) may lead to increased risk of bladder cancer. On the other hand, preventive measures, such as a regular screening program that is offered to employees with past exposure to carcinogenic aromatic amines, may additionally introduce diagnostic bias (33). This may explain in part the increased SIR of bladder cancer in table 3.…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study of shift work and risk of incident cancer among German male chemical workers

Yong¹,

Blettner²,

Emrich³

et al. 2014

Scand J Work Environ Health

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Screening for bladder cancer with urinary tumor markers in chemical workers with exposure to aromatic amines

Cited by 57 publications

References 30 publications

The Health Economics of Bladder Cancer: An Updated Review of the Published Literature

The Health Economics of Bladder Cancer: An Updated Review of the Published Literature

Medical follow-up for workers exposed to bladder carcinogens: the French evidence-based and pragmatic statement

A retrospective cohort study of shift work and risk of incident cancer among German male chemical workers

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