PMID- 28074325
OWN - NLM
STAT- MEDLINE
DCOM- 20180314
LR  - 20180314
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 24
IP  - 6
DP  - 2017 Jun
TI  - Anticipatory Positive Urine Tests for Bladder Cancer.
PG  - 1747-1753
LID - 10.1245/s10434-016-5763-5 [doi]
AB  - PURPOSE: The aim of this study was to establish the criteria defining an 
      anticipatory positive test for bladder cancer. METHODS: We reviewed all patients 
      at our institution who underwent urine cytology or UroVysion fluorescence in situ 
      hybridization (FISH) and cystoscopy from 2003 to 2012. Test performance and 
      cancer anticipation was assessed using generalized linear mixed models, 
      mixed-effects proportional hazards models, and cumulative incidence curves using 
      tests performed within 30 days of each other as well as within a lag time of 
      1 year. RESULTS: Overall, 6729 urine tests (4729 cytology and 2040 UroVysion 
      FISH) were paired with gold-standard cystoscopies. Sensitivity and specificity 
      were 63 and 41% for cytology, and 37 and 84% for UroVysion FISH, respectively. A 
      1-year lag time allowed for cancer anticipation and neither test improved. Among 
      patients with positive cytology and initially negative cystoscopy, the hazard 
      ratio of developing a bladder tumor at 1 year was 1.83; 76% of these patients 
      developed a tumor within 1 year. Similarly, among patients with a positive FISH 
      and initially negative cystoscopy, the hazard ratio of developing a bladder tumor 
      at 1 year was 1.56; 40% of these patients developed a tumor within 1 year. 
      CONCLUSIONS: Urine-based tests for bladder cancer are frequently falsely 
      positive. With further follow-up time, some of these false positive tests are 
      vindicated as true (anticipatory) positive tests, although many will remain false 
      positives. We developed statistical criteria to determine if a test anticipates 
      future cancers or not.
FAU - Gopalakrishna, Ajay
AU  - Gopalakrishna A
AD  - Division of Urology, Duke University Medical Center, Durham, NC, USA.
FAU - Fantony, Joseph J
AU  - Fantony JJ
AD  - Division of Urology, Duke University Medical Center, Durham, NC, USA.
FAU - Longo, Thomas A
AU  - Longo TA
AD  - Division of Urology, Duke University Medical Center, Durham, NC, USA.
FAU - Owusu, Richmond
AU  - Owusu R
AD  - Division of Urology, Duke University Medical Center, Durham, NC, USA.
AD  - Department of Urology, University of California San Diego, San Diego, CA, USA.
FAU - Foo, Wen-Chi
AU  - Foo WC
AD  - Department of Pathology, Duke University Medical Center, Durham, NC, USA.
FAU - Dash, Rajesh
AU  - Dash R
AD  - Department of Pathology, Duke University Medical Center, Durham, NC, USA.
FAU - Denton, Brian T
AU  - Denton BT
AD  - Department of Industrial and Operations Engineering, University of Michigan, Ann 
      Arbor, MI, USA.
FAU - Inman, Brant A
AU  - Inman BA
AD  - Division of Urology, Duke University Medical Center, Durham, NC, USA. 
      brant.inman@duke.edu.
LA  - eng
PT  - Journal Article
DEP - 20170110
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
SB  - IM
MH  - Aged
MH  - Cystoscopy/*methods
MH  - *Cytodiagnosis
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - In Situ Hybridization, Fluorescence/*methods
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Urinalysis/*methods
MH  - Urinary Bladder Neoplasms/*diagnosis/urine
EDAT- 2017/01/12 06:00
MHDA- 2018/03/15 06:00
CRDT- 2017/01/12 06:00
PHST- 2016/10/01 00:00 [received]
PHST- 2017/01/12 06:00 [pubmed]
PHST- 2018/03/15 06:00 [medline]
PHST- 2017/01/12 06:00 [entrez]
AID - 10.1245/s10434-016-5763-5 [pii]
AID - 10.1245/s10434-016-5763-5 [doi]
PST - ppublish
SO  - Ann Surg Oncol. 2017 Jun;24(6):1747-1753. doi: 10.1245/s10434-016-5763-5. Epub 
      2017 Jan 10.