Can this new urine test be PSA for bladder cancer?

[joey]

PSA (Prostate-specific antigen ) test has enabled early detection of prostate cancer for men.    Urine cytology is an equivalent test to detect cancer by detecting cancer cells in urine for men and women. The urine is examined by a pathologist.   However,  urine cytology is not widely used because not only a chance for detecting cancer is small (some says 14%) but also cancer can exist even if cytology test is negative.

Recently, a colleague of mine  has found an article about a new innovative way to detect bladder cancer by urine test.  Basically, their method is to test a certain mutation in fragments of cancer cells in urine by using a modern DNA sequencing.

They tested  67 healthy adults and 118 patients with early-stage.   They compared the result with the test done by cytology.  The result is astonishing in my mind.  Their utDNA (urine test DNA)test identified cancer positive of all the cases cytology found it to be positive (14%).   Also, the urDNA test identified cancer positive for 82% of cases that cytology missed.   If my calculation is not wrong, their utDNA test will detect bladder cancer 85%.  It also means 15% of people with bladder cancer will not be detected by this utDNA, but it is about the same false negative percentage as PSA according to Canadian Cancer Society site.  They also say that their utDNA test outperformed cystoscopy and cytology combined.   Can this be PSA test for bladder cancer or maybe better?

In term of cost for this utDNA test, if I understood right, they use their version of high throughput sequence method – CAncer Personalized Profiling by deep Sequencing (CAPP-Seq).  The cost of CAPP-Seq is US$200-$300 according Wikipedia.  It is a bit higher what PSA cost, which is less than CDN$ 50.   Also, due to advancement in technology, the cost of a DNA sequencing has been declined from a million dollar to less than $1,000 in just 10 years.  I do not see any reason that the cost can come down further in future.

I can think of so many benefits that this utDNA test can bring to bladder cancer patients or bladder cancer candidates.  Personally, I do not mind spending a couple hundred dollars if I can reduce number of my cystoscopy visits without affecting the prognosis of my bladder cancer. But, I am not a medical professional. I love to hear what clinical urolo-oncologists and cancer researchers say about this article.

Hi Jack,  I appreciate very much if you can ask someone in our medical board about this article? Below are links to the related articles.

https://scienceblog.com/505590/

http://cancerdiscovery.aacrjournals.org/content/early/2018/12/21/2159-8290.CD-18-0825

 

 

 

 

 

 

 

 

 

 

[Jack Moon]

Hi Joey
Thanks for posting.
Advised by doctor that the research is “very encouraging, more testing will be required as this just the 1st step but a “giant” step forward.”
Let’s hope that this does move forward very quickly.
Jack

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