Evaluation of DNA flow cytometry as a screening test for bladder cancer

We evaluated DNA flow cytometry of urine histogram profiles as a screening procedure for bladder cancer. To establish the false-positive rate, we first studied a low-risk group of 90 patients with no history of bladder cancer: 24 with benign prostatic hyperplasia and 66 with upper tract stones, and found 4.4% unsatisfactory and 15.1% abnormal histograms. Urine samples were then obtained for 54 additional patients (most being evaluated for benign prostatic hyperplasia) whose selection was based on their smoking habits. These included 20 nonsmokers, 10 who had not smoked for at least 20 years (mean: 18 packs/year) and 24 current smokers (mean: 71 packs/year). Abnormal histograms were obtained for 14% of nonsmokers and for 36% of smokers, a group known to be at risk for developing bladder cancer. Although abnormal histograms are more frequent for smokers, the background false-positive rate remains unacceptably high for general screening purposes.