The research team has been awarded a £100,000 grant from Cancer Research UK (CRUK) to test the performance of a urine-based liquid biopsy test for the disease.  

The test was initially developed under the leadership of Dr Florence Le Calvez-Kelm at the International Agency for Research on Cancer and has already shown early success in the accuracy of detecting the disease in European and Middle Eastern populations.  

The test works by searching for genetic mutations known to occur in a large proportion of bladder cancers. In this new research project, called “UroScan”, the research team will look at 100 bladder cancer cases and the same number of healthy controls who will undergo the test, to assess its accuracy. 

This is the first time the test will be used in a population at high risk of arsenic exposure in Bangladesh. Arsenic is an established bladder carcinogen and affects people in the UK, particularly if using an untreated private drinking water supply.

Participants’ urine samples will also undergo arsenic measurement by Dr Michael Watts and his team of analytical chemists at the British Geological Survey in Nottinghamshire, England. 

Bladder cancer incidence ranks ninth out of all cancers worldwide, with over 600,000 cases and 200,000 deaths annually. In the UK, these numbers are 10,000 and 5,000, respectively, with only 46% of patients surviving for around 10 years. Almost half of bladder cancers are diagnosed at Stage 3 and 4, with poorer prognosis for these later stages. 

The ‘gold standard’ diagnostic procedure for bladder cancer is cystoscopy. As well as being an invasive test involving the insertion of a camera into the bladder, it is more costly in the UK than anywhere else in Europe. Currently, the UK has the third highest worldwide bladder cancer healthcare costs per prevalent case. 

To date, due to their poor performance and low cost-effectiveness, commercially available urine biomarkers are not recommended by urological societies for the screening or management of bladder cancer.  

Commenting on the importance of this project, co-lead on the research, Dr Dan Middleton from the Cancer Epidemiology Group, Centre for Public Health at Queen’s University Belfast, said: “The development of accurate, non-invasive early detection methods are a critical step to reducing bladder cancer burden and diagnostic waiting times, particularly when considered against pre- and post-pandemic pressures on the NHS and its growing backlog of cancer patients.” 

Joint co-lead on the research, Dr Ismail Hosen from the University of Dhaka, said: “Investigating the potential of early detection biomarkers for bladder cancer in an understudied population of Bangladesh is pivotal in the context of reducing the burden of cancer in this region and beyond.” 

Above: Dr Ismail Hosen, Dr Dan Middleton and Dr Florence Le Calvez-Kelm

The researchers have recently commenced the study, and the first results are expected in 2025, before they hope to scale up to a larger UK population-based study.