Bladder Cancer Screening, Signs and Symptoms, and Workup

Despite the frequency of bladder cancer as the fourth most common cancer in men in the USA, there is insufficient data to recommend screening of the general population to detect bladder cancer prior to symptoms. Yet, several small trials of patients at increased risk for bladder cancer have identified cancers at an earlier stage, potentially improving survival. Most patients with bladder cancer will have gross or microscopic hematuria, with other common symptoms including frequency and urgency. An evaluation for bladder cancer includes cystoscopy and imaging of the kidneys and ureters. In the future, a risk-stratified approach for screening and evaluation may improve the specificity of screening and potentially improve survival of patients with bladder cancer.