The following is a summary of “Cxbladder Monitor testing to reduce cystoscopy frequency in patients with bladder cancer,” published in the July 2023 issue of the Urologic Oncology by Li et al.

Surveillance for urinary bladder cancer is associated with high costs and patient burden. CxMonitor (CxM), a home urine test, enables patients to forego their scheduled surveillance cystoscopy if CxM-negative results indicate a minimal likelihood of cancer presence. The researchers present the results of a prospective, multi-institutional study of CxM to reduce the frequency of surveillance during the coronavirus pandemic. Patients eligible for cystoscopy between March and June 2020 were offered CxM and missed their scheduled procedure if CxM was negative. 

Patients who were CxM-positive underwent an immediate cystoscopy. The primary outcome was the safety of CxM-based management, measured by the frequency of omitted cystoscopies and cancer detection at direct or subsequent cystoscopy. Patients were surveyed regarding cost and satisfaction. During the study period, 92 patients received CxM, and there were no demographic or smoking/radiation history differences between sites. On immediate cystoscopy and subsequent evaluation, 9 24 (37.5%) CxM-positive patients had 1 T0, 2 Ta, 2 Tis, 2 T2, and 1 Upper tract urothelial carcinoma (UTUC). None of the 66 CxM-negative patients who did not undergo a follow-up cystoscopy had any findings requiring a biopsy. 

Six patients did not return for follow-up, four opted for additional CxM rather than cystoscopy, two discontinued surveillance, and two passed away for unrelated causes. In terms of demographics, cancer history, initial tumor grade/stage, AUA risk group, and several prior recurrences, there was no difference between CxM-negative and positive patients. The median satisfaction (5/5, IQR 4–5) and the costs (26/33, 78.8% no out-of-pocket expenses) were positive. In real-world contexts, CxM reduces the frequency of surveillance cystoscopy and appears acceptable to patients as a home test.

Source: sciencedirect.com/science/article/pii/S1078143923000091