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Risk-adapted screening in bladder cancer using the open-access Internet-based questionnaire RiskCheck bladder cancer: First evaluation by the health services research foundation IQUO, Germany.

263 Background: Till this day urologists are waiting on symptomatic persons to initiate any diagnostic work-up to identify bladder cancer (BC) patients. In result we diagnose a quarter to a third of our patients as muscle-invasive cancers. The open-access questionnaire RiskCheck bladder cancer (RCBC) was proven in a pilot-study in daily routine from German urologists organized in the health services research foundation IQUO on asymptomatic patients.


METHODS
The open-access RCBC questionnaire was used in urological offices to check asymptomatic patients for their BC risk exposure (personal, smoking, occupation and medical induced). The tool delivers the classical risk stratification in low- intermediate- and high risk. All people with intermediate and high risk were checked for tumor presence by urine diagnostics and in case of suspect results controlled by cystoscopy. Statistical analysis was made by IBM-SPSS 19 for incidence distribution and correlation between risk stratification and tumor detection was proven by classification tree analysis, significance p < 0.05.


RESULTS
Out of 196 checked asymptomatic persons 185 (93.4%) were negative for tumor and 11 had a detectable tumor. In the group of NED 125 (68.1%) persons were classified as low risk, 26 (15.7%) as intermediate and 30 (16.2%) as high risk. Out of the 11 detected tumors 9 were at intermediate or high risk (81.8%). This resulted in an over all detection rate of 5.6% and focused on the risk population of 13.2%. The association of tumor presence and increased risk was significant (p < 0.01). Compared to the western incidence rates this is an increase in effectiveness of 377.


CONCLUSIONS
Risk-adapted screening in bladder cancer delivers a reasonable approach to diagnose bladder cancer before emerging symptoms. The questionnaire RCBC integrates evidence based bladder cancer inductors, is easy in use and as a open-access tool available in 10 languages via the Internet ( www.riskcheck-bladder-cancer.info) .