How does a urine cytology help to detect urinary tract cancers?

Doctor's Answers 2

Urine cytology is a test where a urine sample is sent to the pathology lab to look out for cancer cells.

Bladder cancers are usually transitional cell cancers arising from the urothelium which is the inner lining of the bladder, majority of the urethra (the urine tube where urine exits from the bladder), the ureters (tubes that join the 2 kidneys to the bladder) and the collecting system of the kidneys.

When there is a cancerous growth arising from the urothelium, the cells are shed into the urine and these cells are abnormal and would be detected and the appearance would make the pathologist suspect cancer. However, only the high grade cancers and carcinoma-in-situ cancers of the bladder would shed cells. The low grade bladder cancers usually do not shed cells.

Hence, urine cytology being positive for cancer cells (usually reported as "presence of carcinoma cells") would suggest that there is a cancerous growth in the urinary system arising from the inner lining (urothelium).

But if the urine cytology is negative for cancer cells, this test does not rule out cancer as low grade cancers may not have a positive urine cytology.

If you are unsure what your urine cytology report says, you should show it to a friendly urologist.

Photo of Dr Jipson Quah
Dr Jipson Quah

General Practitioner

Urine cytology is the examination of urothelial cells under the microscope. This allows assessing the cellular nature of the urothelial cells. We study the nuclear and cytoplasmic features which may suggest a urothelial malignancy. Voided urinary cytology is recommended in all patients who have risk factors for urothelial carcinoma. The sensitivity of voided urine cytology for detection of urothelial neoplasm ranges from 18% to 76% and is dependent on factors such as tumor grade, the number of specimens examined, and the expertise of the cytopathologist. Specificity of urine cytology specimens has been reported to be as high as 93%.

Pathologists will categorise their observations and findings and report the likely diagnosis. The Paris system for urine cytology is used to better classify the findings and communicate clinical recommendations to the clinicians and patients.

The Paris System

Urine tests for tumor markers: Newer tests also look for certain substances in urine that might be a sign of bladder cancer. These include:

  1. UroVysion™: This test looks for chromosome changes that are often seen in bladder cancer cells.
  2. BTA tests: These tests look for a substance called bladder tumor-associated antigen (BTA), also known as CFHrp, in the urine.
  3. ImmunoCyt™: This test looks at cells in the urine for the presence of substances such as mucin and carcinoembryonic antigen (CEA), which are often found on cancer cells.

Similar Questions

Are there any alternatives to chemotherapy for breast cancer after a mastectomy?

Chemotherapy is an adjuvant treatment modalty aimed to reduce the overall risk of cancer recurrence. The benefit and need for chemotherapy can vary from patient to patient depending on the stage of cancer, cancer biology, patient baseline health status and relative age of the patient. Stage 3 breast cancers will generally benefit from chemotherapy and omitting it may lead to a high chance of recurrence. Depending on tumour biology and one of which is what we call the receptor status of the tumour ,will dictate if the patient is suitable for endocrine treatment (tablets).

Photo of Dr Radhika Lakshmanan

Answered By

Dr Radhika Lakshmanan

Breast Surgeon

What could be the cause of recurrent nose bleeds?

Simply put. There are benign causes and worrisome ones. If the frequency is unusual and lasting longer than a minute or two, I would advise you to get it checked. At the A&E, our practice would be to first examine where the bleeding occurs, if it’s at the front and easily seen it’s usually due to mucosal injury be it nose digging or blowing your nose very hard. Some medicines like acne medications can cause dry mucosa, as can cold weather and climates.

Photo of Dr Winston  Lee

Answered By

Dr Winston Lee

Aesthetic

Ask any health question for free

I’m not so sure about a procedure...

Ask Icon Ask a Question

Join Human

Sign up now for a free Human account to get answers from specialists in Singapore.

Sign Up

Get The Pill

Be healthier with our Bite-sized health news straight in your inbox