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Abstract
Bladder cancer is a very frequent disease and represents the second most common genitourinary neoplasm. It is the fourth most frequently diagnosed cancer in men and the tenth most frequently diagnosed cancer in women.
Incidence of bladder cancer increases with age. People over the age of 70 develop the disease 2 to 3 times more often than those aged 55–69. In Egypt, the mean age of diagnosis is 46 years with a male: female ratio is 5:1. This pattern is different from that reported in the western countries where; bladder cancer is the second common cancer after the bronchogenic carcinoma affecting adult males and the mean age of diagnosis is 60 years with a male: female ratio is 3: 1.
Two main types of bladder cancers; transitional cell carcinoma and squamous cell carcinoma.
Transitional cell carcinoma is the most common form of bladder cancer accounting for more than 90% of these cancers.
Bladder cancer is currently diagnosed using cystoscopy and cytology in patients with suspicious signs and symptoms. Cystoscopy aided by cytology is the mainstay for diagnosing bladder cancer.
Although cystoscopy is sensitive in the detection of bladder cancer, it is invasive, expensive and uncomfortable for the patients. Urine cytology has until now been the most commonly used marker for detection of bladder cancer,although useful cytology is hampered by subjectivity among cytopathologist and relative insensitivity for moderate and well differentiated tumors.
So the deficiencies of cytology and the invasiveness of cystoscopy render each test suboptimal for tumor surveillance.