TY - JOUR
T1 - Replacing surveillance cystoscopy with urinary biomarkers in followup of patients with non-muscle-invasive bladder cancer
T2 - Patients’ and urologic oncologists’ perspectives
AU - Sayyid, Rashid K.
AU - Sayyid, Abdallah K.
AU - Klaassen, Zachary W A
AU - Hersey, Karen
AU - Goldberg, Hanan
AU - Perlis, Nathan
AU - Ahmad, Ardalanejaz
AU - Leao, Ricardo
AU - Chandrasekar, Thenappan
AU - Fadaak, Kamel
AU - Madi, Rabii Hussein
AU - Terris, Martha Kennedy
AU - Finelli, Antonio
AU - Hamilton, Robert J.
AU - Kulkarni, Girish S.
AU - Zlotta, Alexandre R.
AU - Fleshner, Neil E.
N1 - Funding Information:
Competing interests: Dr. Finelli has attended advisory boards for Amgen, Astellas, and Janssen; and has received honoraria from AbbVie, AstraZeneca, and Ferring. Dr. Hamilton has attended advisory boards for AbbVie, Astellas, Bayer, and Janssen. Dr. Kulkarni has attended advisory boards for Amgen, Astellas, Bayer, Ferring, and Janssen; and has received educational grants from AbbVie and Sanofi. Dr. Zlotta has been an advisor for Ferring, LLC, Sanofi, and 3DBiopsy. Dr. Fleshner has attended advisory boards for AbbVie, Amgen, Astellas, Bayer, Ferring, Janssen, and Sanofi; has received grants from AbbVie, Amgen, Astellas, Bayer, the Canadian Cancer Research Institute, Ferring, Hybridyne Imaging Technologies, Janssen, and Sanofi; and has participated in clinical trials supported by Astellas, Bavarian Nordic, Bayer, Ferring, Janssen, Medivation, Nucleix, Progenics, Sanofi, and Spectracure AB. The remaining authors report no competing personal or financial interests.
Publisher Copyright:
© 2018 Canadian Urological Association
PY - 2018/5
Y1 - 2018/5
N2 - Introduction: Urinary biomarkers are being developed to detect bladder cancer recurrence/progression in patients with non-muscle-invasive bladder cancer (NMIBC). We conducted a questionnaire-based study to determine what diagnostic accuracy and cost would such test(s) need for both patients and urologic oncologists to comfortably forgo surveillance cystoscopy in favour of these tests. Methods: Surveys were administered to NMIBC patients at followup cystoscopy visit and to physician members of the Society of Urologic Oncology. Participants were questioned about acceptable false-negative (FN) rates and costs for such alternatives, in addition to demographics that could influence chosen error rates and costs. Results: A total of 137 patient and 51 urologic oncologist responses were obtained. Seventy-seven percent of patients were not comfortable with urinary biomarker(s) alternatives to repeat cystoscopy, with a further 14% willing to accept such alternatives only if the FN rate were 0.5% or lower. Seventy-five percent of urologic oncologists were comfortable with an alternative urinary biomarker test(s), with 37% and 33% willing to accept FN rates of 5% and 1%, respectively. Forty-seven percent of patients were not willing to pay out-of-pocket for such tests, while 61% of urologic oncologists felt that a price range of $100–500 would be reasonable. Conclusions: This is the first survey evaluating patient and urologic oncologist perspectives on acceptable error rates and costs for urinary biomarker alternatives to surveillance cystoscopy for patients with NMIBC. Despite potential responder bias, this study suggests that urinary biomarker(s) will require sensitivity equivalent to that of cystoscopy in order to completely replace it in surveillance of patients with NMIBC.
AB - Introduction: Urinary biomarkers are being developed to detect bladder cancer recurrence/progression in patients with non-muscle-invasive bladder cancer (NMIBC). We conducted a questionnaire-based study to determine what diagnostic accuracy and cost would such test(s) need for both patients and urologic oncologists to comfortably forgo surveillance cystoscopy in favour of these tests. Methods: Surveys were administered to NMIBC patients at followup cystoscopy visit and to physician members of the Society of Urologic Oncology. Participants were questioned about acceptable false-negative (FN) rates and costs for such alternatives, in addition to demographics that could influence chosen error rates and costs. Results: A total of 137 patient and 51 urologic oncologist responses were obtained. Seventy-seven percent of patients were not comfortable with urinary biomarker(s) alternatives to repeat cystoscopy, with a further 14% willing to accept such alternatives only if the FN rate were 0.5% or lower. Seventy-five percent of urologic oncologists were comfortable with an alternative urinary biomarker test(s), with 37% and 33% willing to accept FN rates of 5% and 1%, respectively. Forty-seven percent of patients were not willing to pay out-of-pocket for such tests, while 61% of urologic oncologists felt that a price range of $100–500 would be reasonable. Conclusions: This is the first survey evaluating patient and urologic oncologist perspectives on acceptable error rates and costs for urinary biomarker alternatives to surveillance cystoscopy for patients with NMIBC. Despite potential responder bias, this study suggests that urinary biomarker(s) will require sensitivity equivalent to that of cystoscopy in order to completely replace it in surveillance of patients with NMIBC.
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U2 - 10.5489/cuaj.4922
DO - 10.5489/cuaj.4922
M3 - Article
AN - SCOPUS:85047325150
SN - 1911-6470
VL - 12
SP - E210-E218
JO - Journal of the Canadian Urological Association
JF - Journal of the Canadian Urological Association
IS - 5
ER -