Physicians do not normally screen patients for bladder cancer and no professional organization recommends that the practice become standard. However, individuals previously diagnosed with bladder cancer and those with risk factors for the condition may benefit from a routine urinalysis, which can detect signs of bladder cancer, such as blood in the urine.

Individuals who suspect they may have bladder cancer, or those who experience any of the signs and symptoms of the condition, should notify their physician. Early detection and treatment of bladder cancer increases a patient’s chance for survival. Diagnosis of this condition typically begins with a complete medical history and a thorough physical examination, which may include an examination of the rectum and of the vagina (in female patients). This examination may help detect the presence and size of a tumor.

The physician may also recommend the following diagnostic tests:

• Cystoscopy. A test in which a cystoscope (a thin tube with a light and a lens) is inserted into the bladder via the urethra, allowing the physician to view the inside of the bladder. If suspicious tissue is detected, a sample is removed in a biopsy and is examined by a pathologist.
  
  
• Urine cytology. A test in which urine or cells flushed from the bladder are sent to a laboratory to determine if precancer or cancer cells are present.
  
  
• Urine culture. A sample of the patient’s urine is sent to a laboratory and analyzed for infection. Symptoms of bladder infection are often similar to those that accompany bladder cancer.
  
  
• Bladder tumor marker studies. Urine tests that identify certain substances that are released into the urine by cancer cells. Although some physicians use these tests, most believe that more research is needed to determine their efficacy.

A number of imaging tests may also be performed to allow the physician to view the kidney, bladder and other organs. These tests can include CT scans, MRI scans, ultrasound, x-rays and bone scans. The tests may provide the physician with additional information about the cancer, such as whether or not it has spread to other organs in the body.

In addition, an intravenous pyelogram may be ordered by the physician. This special x-ray test uses dye to examine the kidneys and ureters, the tubes that drain urine from the kidneys into the bladder.

After the diagnostic tests are performed, the physician will begin the process of staging, or determining the spread of the bladder cancer. Staging any type of cancer is very important because the stage of the cancer determines both the course of treatment and the outlook for recovery.