How is use of urine cytology in bladder cancer?

• Non-invasive test but is not very sensitive (many false negatives). • Urine cytology is of value only if positive. In the event of an abnormality (tumor, atypical or suspicious), a cystoscopy must be performed. • Main indications for urinary cytology: – initial diagnosis of bladder tumor (but always followed by cystoscopy) – monitoring of patients at risk (occupational exposure to carcinogens) – follow-up of patients with a history of bladder tumor not infiltrating the muscle. • Most sensitive and highly specific for high grade tumors (diagnosis or follow-up) whether flat (carcinoma in situ), papillary or mixed • Low sensitivity (difficult to diagnose) for papilloma and low malignant potential lesions