Background:
The incidence of bladder cancer in spinal cord injury (SCI) patients is up to 30 times higher than the general population. Yet, bladder cancer biomarkers have not been assessed in this population. The goal of this study was to evaluate three urine markers; BTA-Stat, cytology, and urinary survivin levels in the SCI population.
Methods:
Between April 1999 and April 2004, 457 unique SCI patients enrolled at the HealthSouth Harmarville Rehabilitation Spinal Cord Clinic donated their urine to our SCI urine repository. BTA stat tests and the survivin assay were performed according to published standards. Cytology specimens were sent to our cytopathology lab for analysis.
Results:
A total of 1075 urine specimens from 457 patients were analyzed. 119 BTA stat tests showed positive reactions while 955 were negative. In the survivin assays, 47 samples had a score of 1, 38 with a score of 2, and 9 with a score of 3. No cytology specimens were noted to have malignant cells. Over the past five years, three patients have been diagnosed with bladder cancer by cystoscopy and treated for superficial disease. Of these patients, neither the BTA stat, survivin, or cytology were positive before the diagnosis of bladder cancer.
Conclusions:
BTA stat, survivin, and urine cytology were not able to predict bladder cancer cases in our cohort of SCI patients. Cystoscopy, therefore, remains the gold standard in SCI patients for bladder cancer surveillance

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