Urothelial bladder cancer, the fourth most common cancer in men and the eighth most common in women, accounts for more than 54,000 new cases and 11,200 deaths annually. Cystoscopy and cytology, used to detect this transitional cell cancer in situ, have significant drawbacks, including relatively low sensitivity, patient discomfort, and infection risks. Now, a new U.S./European research consortium wants to create a simple, cost-effective, noninvasive diagnostic test to replace cystoscopy and cytology. Later this year, the consortium, which includes Yale University researcher Dario C. Altieri, will initiate multicenter trials to find which of seven recently identified molecular markers, alone or in combination, is the most accurate detector of bladder cancer.

One of the most promising markers is survivin, an enzyme inhibitor of apoptosis (IAP) that is selectively overexpressed in human cancers and correlates highly with the disease but not with healthy tissue. The protein is produced by the...

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