What are the tests to diagnose bladder cancer? (2024)

You usually have a number of tests to diagnose bladder cancer and find out how far it has grown. These include:

  • a test to look inside your bladder (cystoscopy)
  • tests to look at your kidney, bladder and ureters (CT urogram)
  • scans to look at your bladder and the rest of your body (ultrasound, MRI scan, CT scan, PET-CT scan)

Tests your GP might do

Most people start by seeing their GP. They can do some tests to help them decide whether you need a referral to a specialist. Your GP might:

  • test your wee (urine)

  • examine inside your back passage or vagin* to see if everything feels normal

Urine test for bladder cancer

Your GP can do a quick test to see if there is any blood in your urine. They dip a testing stick into a fresh sample of your urine. They might send a sample of your urine to the laboratory. This is to check for other causes of your symptoms, such as an infection.

Internal examination

Your GP may want to examine you internally.

They put a gloved finger into your back passage (rectum) orvagin*. This is to see if everything feels normal. The doctor can sometimes feel a bladder tumour during this type of examination.

They will refer you to a specialist (called a urologist) at a hospital if they think there’s any chance your symptoms could be due to a cancer.

Tests your specialist might do

Depending on the results of your tests, your GP might refer you to a specialist. You usually see a urologist. This is a doctor who specialises in treating problems of the urinary tract such as the prostate, bladder and kidneys.

Your specialist usually does more tests. These include:

  • Ultrasound scan of your tummy (abdomen)
  • Cystoscopy for bladder cancer - to look inside your bladder
  • CT urogram - to check your kidneys, bladder and ureter
  • Blood tests for bladder cancer
  • MRI scan
  • CT scan
  • PET CT scan
  • Bone scan

Ultrasound scan for bladder cancer

Ultrasound scans use high frequency sound waves to create a picture of a part of the body. You might have an ultrasound scan of your tummy (abdomen). The scan looks at your urinary system (the bladder, kidneys, ureter and urethra).

The ultrasound scan can show if there are any signs of cancer in your bladder. It can also show any blockages in the tubes that move urine between your kidneys and bladder (the ureters).

  • Find out more about having an ultrasound scan

Cystoscopy for bladder cancer

Cystoscopy is a test to look at the inside of your bladder and check for signs of cancer. Your doctor can take samples of the bladder lining (biopsies) to check for cancer cells.

There are different types of cystoscopies including:

  • flexible cystoscopy
  • rigid cystoscopy
  • narrow band imaging
  • blue light cystoscopy or photodynamic diagnosis (PDD)

Your doctor will discuss with you what type of cystoscopy you're having.

You can have a cystoscopy when you are awake under a local anaesthetic. Or under a general anaesthetic which means you are asleep.

  • Read more about having a cystoscopy

CT urogram

This is a test to look at your kidneys, bladder and ureters. Ituses a CT scan and special dye (contrast medium) to look at your:

  • kidneys
  • bladder
  • tubes that connect the kidneys to your bladder (ureters)

A CT scan uses x-rays to take detailed pictures of your body from different angles. A computer then puts them together to make a 3 dimensional (3D) image. CT stands for computed (axial) tomography.

You might have a CT urogram to check for the cause of your symptoms. For example, to find out where the blood in your urine is coming from. This test also shows where the cancer is and how big it is (stage).

  • Find out more about having a CT urogram

Blood tests for bladder cancer

A blood test can check your general health, including how well your liver and kidneys are working. The doctors will also check numbers of blood cells.

  • Find out more about blood tests

MRI scan

MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.

You might have an MRI scan to see if the cancer has:

  • grown into the deeper muscle layer of the bladder
  • spread to other parts of your body
  • Find out more about having an MRI scan

CT scan

CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.

You might have a CT scan of your pelvis and tummy (abdomen) and your chest. It can tell your doctor where the cancer is, how big it is and if the cancer has spread.

  • Read more about having a CT scan

PET-CT scan

A PET-CT scan combines a CT scan and a PET scan.

The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal.

You might have a PET-CT scan:

  • to find out the size of the cancer and whether it has spread (the stage)
  • before surgery to assess what type of operation you need
  • to show how well your treatment is working
  • Find out more about having a PET-CT scan

Bone scan

A bone scan shows up changes or abnormalities in the bones. You might have a bone scan if you have some symptoms and your doctor wants to check if the bladder cancer has spread to your bones.

  • Find out more about how you have a bone scan
What are the tests to diagnose bladder cancer? (2024)

FAQs

What are the tests to diagnose bladder cancer? ›

The most common way is to look at the cells under a microscope, called urinary cytology. There are other urine tests using molecular analysis that can be done to help find cancer, usually at the same time as urinary cytology. Cystoscopy. Cystoscopy is the key diagnostic procedure for bladder cancer.

What is the most reliable test for detecting bladder cancer? ›

Pathology Tests

The most efficient, noninvasive and inexpensive test is a urinalysis/cytology.

What test is most definitive in diagnosing bladder cancer? ›

If bladder cancer is suspected, a biopsy is needed to be sure of the diagnosis. The procedure used to biopsy an abnormal area is a transurethral resection of bladder tumor (TURBT), also known as just a transurethral resection (TUR).

What is the gold standard for diagnosing bladder cancer? ›

Urine cytology remains the gold standard for bladder cancer screening. It is the test against which all others are compared when evaluating potential bladder tumor markers.

What lab results indicate bladder cancer? ›

Tests for bladder cancer look for different substances and/or cancer cells in the urine. Urinalysis: One way to test for bladder cancer is to check for blood in the urine ( hematuria). This can be done during a urinalysis, which is a simple test to check for blood and other substances in a sample of urine.

What mimics bladder cancer? ›

The symptoms of urinary tract infections (UTIs) and the symptoms of bladder cancer can be very similar. Both may involve pain while urinating, a feeling of urgency, frequent urination, and the presence of white or red blood cells in the urine.

How accurate is a cystoscopy in detecting bladder cancer? ›

Among 181 cystoscopies with clinically negative results that underwent a follow-up cystoscopy, 17 patients (9.4%) were subsequently diagnosed with bladder cancer, with the lesions identified in the initial cystoscopy. The sensitivity and specificity of cystoscopy in these cases were 81% and 73%, respectively.

What are the odds of beating bladder cancer? ›

The 5-year relative survival rate of people with bladder cancer that has not spread beyond the inner layer of the bladder wall is 96%. Almost half of people are diagnosed with this stage. If the tumor is invasive but has not yet spread outside the bladder, the 5-year relative survival rate is 70%.

How fast does bladder cancer spread without treatment? ›

Fortunately, the majority of bladder cancers do not grow rapidly and can be treated without major surgery. Thus, most patients with bladder cancer are not at risk of developing a cancer that will spread and become life threatening.

How accurate is urine test for bladder cancer? ›

Urine cytology examines the morphological changes in exfoliated cells from the urinary tract to assess abnormalities (Woldu et al., 2017). The sensitivity of urine cytology varies with cancer grade. In high-grade urothelial cancer, the sensitivity is as high as 86%, but 20–50% in low-grade cancers (Zhu et al., 2019).

What are three diagnostic tests used to confirm bladder cancer? ›

Tests and procedures used to diagnose bladder cancer may include:
  • Using a scope to examine the inside of your bladder (cystoscopy). ...
  • Removing a sample of tissue for testing (biopsy). ...
  • Examining a urine sample (urine cytology). ...
  • Imaging tests.

How accurate is CT scan for bladder cancer? ›

While a CT scan can detect larger bladder tumors, it is not sensitive enough to detect small tumors or flat tumors in the bladder. CT is most useful to evaluate the kidneys and ureters and the area around the bladder and lymph nodes, as well as evaluate other organs in the body.

What is the FDA approved test for bladder cancer? ›

NMP22 stands out as the protein that has been the most extensively investigated and has been used to diagnose bladder cancer and monitor its recurrence. Both the NMP22 Bladder Cancer ELISA, a quantitative test, and the NMP22 BladderChek, a point-of-care test, have received FDA approval for surveillance [76].

What does Stage 1 bladder cancer feel like? ›

The first sign of bladder cancer is blood in the urine, which is painless for most people. In the early stages, this may be your only symptom, though some people don't experience it. Other symptoms include changes in bladder habits, frequent urinary infections, and pelvic or back pain, which might be on one side.

How long can you have bladder cancer without knowing? ›

Can bladder cancer go undetected for years? If symptoms such as blood in the urine and changes in urinary habits are ignored by an individual and/or repeatedly misdiagnosed, it's possible that bladder cancer may not be detected for months or, in some cases, even years.

Does bladder cancer show on a CT scan? ›

A CT or MRI scan can sometimes show if and how far the bladder cancer has spread, but you might also need other imaging tests such as a radioisotope bone scan, x-rays or a PET–CT scan.

How accurate is a CT scan for bladder cancer? ›

How often does a CT scan miss bladder cancer? Most of the time, CT scans are very accurate, though false negatives and false positives can happen. A 2018 study found that some false positives can occur. Researchers cited 13 false negatives out of 710 scans.

Can bladder cancer be missed on cystoscopy? ›

Until recently it was assumed that the standard procedure, white light cystoscopy (WLC) was accurate but it is now accepted that this will miss some bladder cancers. One particular type of bladder cancer called carcinoma in situ (CIS) although rare is easy to miss when using WLC.

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