\u00a0<\/span><\/p>\n Surveillance for non-muscle-invasive bladder cancer (NMIBC) relies on routine white-light cystoscopy (WLC) and urinary cytology as the diagnostic cornerstone [1]. WLC demonstrates a sensitivity of approximately 86% for detecting papillary tumours, while specificity varies widely between 43% and 98% [2,3] depending on the examiner\u2019s experience. The sensitivity of WLC in carcinoma in situ (CIS) is even lower than in papillary lesions, resulting in a substantial rate of overlooked tumours \u00a0[2]. Similarly, urinary cytology has only a moderate sensitivity of 54% for detecting high-grade (HG) tumours, meaning that about 46% of HG tumours, including CIS, are missed [4].<\/p>\n Recently published real-world data suggest that Bladder EpiCheck\u00ae (BE) may achieve more efficient detection of HG recurrences compared to WLC, particularly for detecting CIS [5].<\/p>\n Within this study, 315 surveillance visits were analysed. At each visit, patients underwent both WLC and BE testing. Positive WLC and\/or positive \u00a0BE results led to photodynamic diagnosis (PDD)-guided biopsy or resection under general anaesthesia, whereas pathology result was used as the diagnostic reference.<\/p>\n Comparative diagnostic performance<\/strong><\/p>\n BE outperformed WLC, particularly for detecting HG and CIS lesions:<\/p>\n BE identified 60% more HG recurrences than WLC. Among HG tumours missed by WLC but detected by BE, 73% were CIS. Overall, WLC detected only 38% of CIS lesions versus 92% with BE. In addition to superior HG detection, BE identified all low-grade recurrences (7\/7), compared to WLC (4\/7), indicating consistent performance across grades.<\/p>\n The lower sensitivity of WLC at 63% for HG disease compared to typical literature values stems from using PDD-guided biopsy triggered by a positive BE result as the rigorous gold standard, which uncovers many flat CIS lesions invisible under WLC. In this study, PDD-guided biopsy captured additional HG recurrences (mostly CIS) that WLC missed, unlike studies using only WLC-targeted resection histology as reference.<\/p>\n The modest PPV mainly reflects anticipatory positives from BE As longer follow\u2011up and PDD\u2011guided biopsies confirm these initial \u201cfalse positives\u201d as real recurrences, PPV rises toward 70%, indicating BE uncovers clinically relevant but initially invisible cancer.<\/p>\n BE\u2019s high NPV (99%) and specificity (93%) for HG tumours mean that a negative BE result is associated with a very low likelihood of missed aggressive disease.<\/p>\n Clinical interpretation<\/strong><\/p>\n A surveillance approach guided by BE with PDD-guided biopsy reserved for BE-positive cases could potentially reduce 93% of the unncessary cystoscopies, while still detecting nearly all HG recurrences. This\u00a0<\/span>strategy would allow earlier and more efficient identification of aggressive recurrences.<\/span><\/p>\n These findings provide real-world evidence that a marker-guided, risk-adapted model can be both safe and feasible <\/strong>and aligns with the recently published German UroFollow trial, which also showed that marker\u2011based follow\u2011up can safely reduce cystoscopy intensity in NMIBC [6].<\/p>\n <\/p>\n \u00a0<\/strong><\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ custom_margin=”||-6px|||” custom_padding=”0px||0px|||” locked=”off” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ custom_margin=”0px||0px||false|false” custom_padding=”0px||0px||false|false” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_column type=”4_4″ _builder_version=”4.16″ global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_text _builder_version=”4.16″ header_text_color=”#3b8dbf” background_size=”initial” background_position=”top_left” background_repeat=”repeat” min_height=”191.8px” custom_margin=”45px|||||” custom_padding=”0px|||||” global_colors_info=”{}” theme_builder_area=”post_content”]<\/p>\n [\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":" Improving detection of high-grade recurrences missed by WLC using a urinary biomarkerReviewed by Marek Babjuk \u00a0 Surveillance for non-muscle-invasive bladder cancer (NMIBC) relies on routine white-light cystoscopy (WLC) and urinary cytology as the diagnostic cornerstone [1]. WLC demonstrates a sensitivity of approximately 86% for detecting papillary tumours, while specificity varies widely between 43% and 98% […]<\/p>\n","protected":false},"author":0,"featured_media":299,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-353","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-publication"],"_links":{"self":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts\/353","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=353"}],"version-history":[{"count":1,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts\/353\/revisions"}],"predecessor-version":[{"id":358,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/posts\/353\/revisions\/358"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=\/wp\/v2\/media\/299"}],"wp:attachment":[{"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=353"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=353"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bcamonitor.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/bcamonitor.org\/wp-content\/uploads\/2026\/01\/capture4.jpg\")
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<\/p>\n[References]<\/h5>\n
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