NMP-22 for bladder cancer screening and surveillance

In 2004, more than 56,000 Americans will be diagnosed with bladder cancer (American Cancer Society, 2004). Urethrocystoscopy is considered the gold standard for bladder cancer diagnosis, but it is not a screening test. Researchers have been challenged to develop a noninvasive urine test that reliably differentiates hematuria associated with bladder cancer from that associated with nonmalignant etiologies. Several well-established and some novel tests for bladder cancer screening diagnosis and surveillance, including urinalysis, voided cytology, and the Nuclear Matrix Protein 22 (NMP-22) assay, one of a growing number of assays developed as a specific, sensitive noninvasive test for bladder cancer, are reviewed. Until the sensitivity of the NMP-22 is improved, or another urine assay emerges that provides significantly greater sensitivity while maintaining adequate specificity, urethrocystoscopy will remain the reference test for detecting and diagnosing bladder cancer and its recurrence.