HealthcareHow to Detect Bladder Cancer: Non-Invasive Testing Options

Cancer is a worrying threat, but thankfully, our ability to detect and treat it is improving. Still, it’s important to respond quickly to any symptoms to ensure you can identify conditions like bladder cancer early enough. Signs like blood in urine may not necessarily mean there’s a cancerous growth, but they’re worth inspecting.

How Common Is Bladder Cancer?

Bladder cancer is the fourth most common cancer in men, though it’s far less prevalent in women. Overall, it accounts for roughly 4% of all cancers in the U.S., with men having a one in 28 chance of developing it and women facing a one in 89 chance. Of course, risk factors like smoking, a lack of hydration and exposure to certain chemicals can increase those odds.

In 2024, the U.S. saw about 83,190 new cases of bladder cancer. Of those, 63,070 were male patients, while the other 20,120 were women. There were also 16,840 deaths from bladder cancer that year — 12,290 of which were in men and 4,550 in women.

As with many cancers, the older you are, the greater your risk of developing this condition. According to the American Cancer Society, roughly nine in 10 cases are in people over the age of 55. Still, you should consider a bladder cancer test if you notice any prevalent symptoms.

What Are the Symptoms of Bladder Cancer?

The biggest sign of bladder cancer is blood in urine, also known as hematuria. This blood isn’t always as evident as you may think, but if your urine has changed to a pink or orange color, it may be worth checking out. Hematuria can also come and go from day to day.

Changes in urination habits can be another sign of bladder cancer. These include going to the bathroom more frequently, pain while going, urinating a lot during the night and feeling the urge to go even if your bladder isn’t full.

In some cases, the cancer can spread to other areas and cause symptoms there. While these situations are unlikely — doctors catch 50% of all bladder cancer cases while it’s still in the originating cell layer — some people still experience them. Symptoms of spreading bladder cancer may include:

• Being unable to urinate
• Pain in the lower back on one side
• Abdominal pain
• Bone pain
• Unexplained weight loss
• Unusual tiredness

How to Detect Bladder Cancer: Non-Invasive Options

Some of the best bladder cancer tests are non-invasive, meaning they don’t involve anything entering your body. Here’s how to test for bladder cancer without an invasive procedure.

Urine Cytology

Cytology is the most common non-invasive method for checking for bladder cancer. Here, doctors take a sample of your urine, which you may provide from a take-home kit or at the hospital. Then, medical staff will examine the sample under a microscope to check for abnormal cells.

It’s important to note that “abnormal” can mean a lot of things. While it could indicate bladder cancer, it could also result from a different kind of inflammation or an infection. Consequently, cytology alone cannot diagnose cancer — rather, it suggests whether further testing may be necessary.

An abnormal cytology result will usually lead your doctor to order a biopsy or similar procedure to look at your bladder tissue more closely. The need for a second step may be frustrating, but because the cytology itself is non-invasive, it’s convenient for patients who get a normal result. There’s no need for a longer, more disruptive exam if everything comes back clear.

Genomic Urine Tests

Genomic urine tests are a similar but distinct method. Like cytology, these analyze a urine sample. However, instead of looking for abnormal cells, they look for genetic markers.

1. Cxbladder

One of the most prevalent genomic urine tests is Cxbladder, which looks at messenger RNA (mRNA) levels in five specific biomarkers. Studies show that mRNA levels in these genes are different in bladder cancer patients than cancer-free subjects. Consequently, Cxbladder is a more focused approach than urine cytology but feels much the same on the patient’s end. It’s also a good way to look for recurrence in patients who’ve undergone treatment for bladder cancers without needing an invasive test.

2. UroAmp MRD

UroAmp MRD is another genomic urine test. Whereas Cxbladder looks at mRNA levels, this test searches for a wider range of cancer genes. The process is largely the same — you submit a urine sample that a lab then analyzes — but it predicts the likelihood of cancer differently. It’s less targeted but could cast a broader net to detect potential bladder cancer cases.

3. UroSEEK

A newer option is UroSEEK. UroSEEK looks for cancer-indicating mutations in 11 often-impacted genes and changes across 39 chromosome arms. It’s particularly useful for detecting low-grade bladder cancers, but as a newly developed test, it’s had less real-world use to showcase its accuracy and reliability.

Imaging Tests

Some doctors may order an imaging test if there’s blood in your urine. Imaging covers a broad range of specific procedures, including X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and ultrasounds. Whatever the specifics, these tests let doctors see what your urinary tract looks like, helping them find tumors or other abnormalities.

Imaging usually doesn’t take long, but it must happen at a hospital, not at home, because it involves specialized equipment. It may also be unable to catch bladder cancer in its early stages, as cancerous cells may not show up until they grow. However, it is a useful way to see if cancer has spread to other areas.

In most cases, imaging follows another type of test. Doctors may order it after identifying cancer through a biopsy, for example. In other situations, medical professionals may perform these tests first to rule out possibilities like a urinary tract infection (UTI) or kidney stone.

How to Detect Bladder Cancer: Invasive Options

Some non-invasive bladder cancer tests will warrant further inspection through a more invasive procedure. Cystoscopies and biopsies are the two most common methods.

Cystoscopy

A cystoscopy is the dominant method of checking for urine cancers and other lower urinary issues. This involves a tiny camera on the end of a flexible tube that doctors use to visually examine your body. It’s similar to a colonoscopy, but instead of looking into a patient’s colon, it allows doctors to see inside the urethra and bladder.

Cystoscopies have been around for a long time, and doctors perform about one million of them annually in the U.S. alone. As popular as they are, though, they’re not a perfect measure. Most notably, because they’re a visual inspection, they rely on visible markers, which aren’t always present or easy to detect.

Not every instance of bladder cancer will produce easily identifiable growths or lesions. Relying on such visual signs may also mean cystoscopies fail to catch some early-stage conditions. There’s also a fair amount of room for human error, although machine vision innovations could address that issue.

Biopsy

Biopsies are another invasive way to test for bladder cancer. A biopsy involves taking a sample of tissue cells from your bladder to test in a lab for further inspection. It’s often a follow-up measure after a cystoscopy reveals something suspicious, and you may see it referred to as a transurethral resection of bladder tumor (TURBT).

While TURBT may sound intense, it’s not as disruptive as it initially sounds. Doctors can retrieve the tissue sample without making an incision, and they don’t take much. Still, it is invasive, albeit minimally so.

With a tissue sample, doctors can look for cancer cells under a microscope or run genetic market tests. As a result, biopsies offer greater confidence in the diagnosis than a cystoscopy alone. However, it takes several days for results to come back and because it’s usually a follow-up procedure, the overall process is long and involves multiple hospital visits.

Benefits of Non-Invasive Bladder Cancer Tests

Non-invasive bladder cancer tests like Cxbladder have several advantages over older, invasive methods. It’s worth considering these before deciding how to respond to blood in your urine or other symptoms.

Early Detection

One of the most significant benefits of non-invasive testing is that it can spot cancer in the early stages. Early detection improves cancer survival rates, as it lets doctors treat it before it advances to a more dangerous phase. However, conventional methods don’t always enable such proactive action.

Looking at cells and genes may help doctors notice abnormal signs before larger visible symptoms that would appear in a cystoscopy. Patients are also more likely to be comfortable with a non-invasive test. As a result, these exams encourage a wider number of patients to look into things before experiencing extreme symptoms, leading to earlier detection.

Thankfully, doctors tend to uncover bladder cancer in its initial stages today. The rise of non-invasive methods could play a role in that, although it’s difficult to draw a direct cause-and-effect relationship. Regardless, the existence and precision of these tests are a considerable help.

Minimal Complications

Less invasive means of testing for bladder cancer are also preferable for their safety. While doctors perform many cystoscopies and other invasive tests each year, there’s always some room for complications. Non-invasive alternatives remove this threat.

Despite major advances in medical sanitation standards, roughly one in 31 patients has a health care-associated infection on any given day. These can stem from cross-contamination from equipment or human error, but in all cases, anything entering your body makes them more likely. Because non-invasive tests avoid any such interaction, there’s minimal risk of infection.

Infections from cystoscopies and biopsies are unlikely, and serious complications are even rarer. Still, the chance of developing one can be an uncomfortable prospect for some patients. Removing the possibility of these complications entirely by opting for a non-invasive alternative is a welcome change.

Increased Accessibility

Non-invasive bladder cancer tests are also more accessible than older methods. Cystoscopies and biopsies require special equipment and expert handling, so you have to go to a hospital or clinic for them. By contrast, genomic tests are possible to perform in the comfort of your own home.

Collecting a sample for Cxbladder or similar alternatives doesn’t require any medical knowledge or machinery. While it may take over a week to get results back, your involvement as the patient takes mere minutes. This ease of use means you can avoid traffic, finding a doctor’s office that takes your insurance and other complications with in-person services.

Increased accessibility translates into better patient outcomes over time. Limited resource availability and transportation inconveniences increase the risk of poor health, and the inverse is also true. Removing these barriers through an at-home test means more people can get the help they need.

Choosing a Non-Invasive Bladder Cancer Test

Given these advantages, it’s a good idea to opt for a non-invasive test if you notice symptoms like blood in urine. You may need further examination down the line, but if you’re in the clear after the initial screening, you can rest without any invasive procedures. However, you must still choose between non-invasive options.

In general, anything you can perform from home is a good first step. Tests like Cxbladder and other genomic methods are ideal because they require no travel or scheduling. That’s especially handy for the 60 million Americans who live in rural areas, where the nearest hospital is sometimes 20 miles or more away.

Quick results are also something to look for, as the sooner you learn of cancer, the more effectively you can treat it. You’ll also want to opt for a solution with a high degree of reliability and precision. While many bladder cancer tests today have low false positive rates, some don’t produce precise results — they may indicate cancer, or they could be something else.

Why Do I Have Blood in My Urine if Not Cancer?

While blood in urine is the most common sign of bladder cancer, most cases of hematuria are not instances of cancer. You may have blood in your urine for several reasons, including:

• Kidney stones
• Kidney infections
• UTIs
• Urinary tract trauma
• Some medications

Thankfully, most of these conditions are not life-threatening. However, all need treatment, and the risk of cancer always demands thoroughness. Consequently, it’s best to consult your doctor and seek out further testing if you notice any blood in your urine.

Blood in Urine Always Warrants a Closer Look

Symptoms like hematuria and unexplained pain can be worrying, but modern medicine has made it easier than ever to look into the causes. Non-invasive bladder cancer tests like Cxbladder mean you can avoid complications and busy hospitals while still getting a better picture of your health. Don’t hesitate to consult a medical professional after noticing possible cancer symptoms. It’s easy and crucial to test as early as you can.