A urine test posted from home could replace the uncomfortable hospital procedure currently used to check for bladder cancer in people with blood in their urine. Only one in ten patients with haematuria actually has bladder cancer, yet all must undergo cystoscopy—a procedure where a camera is passed up the urethra. This costs the NHS an estimated £55.39 million annually, making bladder cancer one of the most expensive cancers to manage. The test, called UroMark, uses highly multiplexed targeted sequencing to detect 150 epigenetic alterations in cells shed into urine. In proof-of-concept studies, it discriminated between bladder cancer and normal tissue with high sensitivity and specificity. If the assay performs as well in clinical use, it could dramatically reduce the need for cystoscopy. Patients would provide a urine sample at home and send it by post. The NHS would save money on unnecessary procedures, and patients would avoid the discomfort and infection risk of an invasive test. The research is translational—it takes a fundamental understanding of epigenetic changes in bladder cancer and turns it into a practical diagnostic tool ready for the clinic.
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Investigation for bladder cancer in patients with blood in their urine (haematuria) is important and incurs a cost to UK healthcare estimated at £55.39 million per year ranking bladder as one of the most expensive cancers to manage. Although haematuria is a sign of bladder cancer only 10% of patients with haematuria will be found to have cancer. In the majority of instances a non cancer cause and frequently no cause is found. The assessment of haematuria involves passing an instrument along the urethra, or water pipe, to view the lining of the bladder wall. The assessment known as cystoscopy is uncomfortable, carries a low but significant risk of infection and requires referral from a GP to hospital. We have developed a test which uses cutting edge technology known as highly multiplexed targeted sequencing to detect cancer specific changes known as epigenetic alterations in cells which can be collected from urine. A urine sample for testing can be provided at home and sent to our lab using the postal system. The test, UroMark, utilises a platform known as RainDrop BS-Seq to analyse a panel of 150 epigenetic alterations which accurately discriminate between bladder cancer and normal. In proof of concept studies the test performs with high sensitivity and specificity for the detection of bladder cancer. The incorporation of a highly sensitive and specific assay will revolutionise bladder cancer pathways, have a profound impact on the requirement for cystoscopy and on patient wellbeing and, reduce the healthcare costs associated with investigation of haematuria and surveillance for disease recurrence.
Andrew Feber (Co-Investigator)Chris Brew-Graves (Co-Investigator)John Kelly (Principal Investigator)Martin Anyim (Co-Investigator)Norman Williams (Co-Investigator)Stephan Beck (Co-Investigator)
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