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Bladder cancer incidence ranks ninth out of all cancers worldwide, with over 600 000 cases and 200 000 deaths annually. In the UK, these numbers are 10 000 and 5000, respectively, with only 46 per cent of patients surviving for around 10 years. Almost half of bladder cancers are diagnosed at stages 3 and 4, with poorer prognosis for these later stages.

The ‘gold standard’ diagnostic procedure for bladder cancer is cystoscopy. As well as being an invasive test involving the insertion of a camera into the bladder, it is more costly in the UK than anywhere else in Europe. Currently, the UK has the third-highest bladder cancer healthcare costs per prevalent case in the world.

A research team that includes chemical analysts from ���ճԹ� has been awarded a grant from Cancer Research UK to test the performance of a urine-based liquid biopsy test for the disease. To date, due to their poor performance and low cost-effectiveness, commercially available urine biomarkers have not been recommended by urological societies for the screening or management of bladder cancer.

The new test, which works by searching for genetic mutations known to occur in a large proportion of bladder cancers, was initially developed under the leadership of Dr Florence Le Calvez-Kelm at the . It has already shown early success in the accuracy of detecting the disease in European populations. In this new research project, called ‘UroScan’, the team will look at 100 bladder cancer cases and the same number of healthy controls, who will all undergo the test to assess its accuracy.

This is the first time the test will be used in a population at high risk of arsenic exposure in Bangladesh. Arsenic is an established bladder carcinogen and affects people in the UK as well, particularly those using an untreated private drinking water supply. Participants’ urine samples will undergo arsenic measurement by Dr Michael Watts and his team of analytical chemists at ���ճԹ�.

The development of accurate, non-invasive early detection methods are a critical step to reducing bladder cancer burden and diagnostic waiting times, particularly when considered against pre- and post-pandemic pressures on the NHS and its growing backlog of cancer patients.

Dr Dan Middleton, Cancer Epidemiology Group, Centre for Public Health at Queen’s University Belfast.

Investigating the potential of early detection biomarkers for bladder cancer in an understudied population of Bangladesh is pivotal in the context of reducing the burden of cancer in this region and beyond.

Dr Ismail Hosen, University of Dhaka, joint lead researcher.

This project builds on a collaboration of more than 10 years of refining the methodologies to better understand the potential exposure to arsenic in the environment and to inform the consequences for human health to stimulate approaches to reduce exposure.

Dr Michael Watts, head of ���ճԹ� Inorganic Geochemistry.

The researchers have recently started the study and the first results are expected in 2025, before hopefully scaling up to a larger, UK population-based study that will incorporate exposure to arsenic in highly mineralised locations in rural areas, where private water supplies are most common.