Three-year follow-up of bladder tumours found on screening

The clinical course, over a period of 3 years, of 17 bladder tumours found on screening a male population (2356 individuals) aged over 60, is reported. Even with this relatively small population, the importance of distinguishing pathologically between a pTa and a pT1 tumour is emphasised. The progression rate to date of pT1 tumours (1 of 9: 11%) is significantly less than that reported in larger studies on symptomatic patients. The simplicity of this screening process, together with the ease of out-patient investigation (combining ultrasound, flexible cystoscopy and urine cytology) indicate the need for a comprehensive prospective randomised trial to test the efficacy of screening for bladder tumours in populations who are known to be at risk.