Xpert Bladder Cancer Detection in Emergency Setting Assessment (XESA Project): A Prospective, Single-centre Trial

Area of Science:

• Urology
• Oncology
• Diagnostic Medicine

Background:

• Bladder cancer (BC) diagnosis presents challenges, particularly in emergency departments (EDs) for patients with haematuria.
• There is a need for more efficient and accurate diagnostic tools for bladder cancer in the ED setting.

Purpose of the Study:

• To evaluate the clinical performance of the Xpert Bladder Cancer Detection (BCD) test.
• To assess the economic implications of using Xpert BCD for patients presenting with haematuria in the ED.
• To compare Xpert BCD against standard diagnostic methods like urine cytology (UC) and white-light cystoscopy (WLC).

Main Methods:

• A prospective, single-centre observational study was conducted in an ED.
• Urine samples from patients with gross haematuria were analyzed using the Xpert BCD test.
• Sensitivity, specificity, and cost analysis were primary outcomes compared to UC and WLC.

Main Results:

• Xpert BCD demonstrated superior sensitivity compared to UC, especially for high-grade bladder cancers.
• Implementation of Xpert BCD may reduce unnecessary WLC procedures and streamline diagnostic pathways.
• Cost analysis indicated potential cost savings with Xpert BCD adoption in the ED.

Conclusions:

• Xpert BCD shows promise for improving bladder cancer diagnosis in ED patients with gross haematuria.
• The test's sensitivity and efficiency can enhance patient care and optimize resource utilization.
• Adoption of Xpert BCD may alleviate the economic burden associated with current diagnostic procedures.