Telomerase and Other Novel Approaches to Bladder Cancer Detection

Extract

Over 68,000 new cases of urinary bladder cancer are expected in the United States in 2008. Of these, an estimated 13,000 people will die of this disease. Urinary bladder cancer is the fourth most common new cancer in men and the ninth most common in women, with incidence rates of 30.0 and 7.1 per 100,000, respectively.¹

Bladder cancer can be divided into two broad categories relating to the severity of disease. The first affects 70% of the patients and is characterized by low-grade tumors with frequent subsequent recurrence. Patients with low-grade malignancies have a good prognosis and low mortality rate. The remaining 30% of patients have high-grade tumor lesions. While both categories are associated with frequent recurrences, patients with high-grade lesions are at high risk for metastasis to other organs and tissues. Patients in this category have particular need for accurate diagnosis and staging in order to improve survival rates.²

The greatest utility for a bladder cancer-screening program is in high-risk populations, i.e., those who have previously had urological cancer. The relatively low incidence rate (44 patients per 100,000 population) makes a general screening program unlikely due to the risks and costs associated with cystoscopy and cytology, the current screening methods.³ However, screening individuals at high risk is beneficial for early bladder cancer detection. Thus, there is a real need for an accurate and non-invasive screening assay with high sensitivity and specificity to be used in these populations.

Urine tumor markers are a promising area of oncologic medicine with the…

ABBREVIATIONS: hTERT = human telomerase reverse transcriptase; hTR or hTERC = human telomerase RNA component; PCR = polymerase chain reaction; RUO = research use only; TRAP = telomeric repeat amplification protocol.