Blue Light Cystoscopy in Patients with Suspected Non-Muscle Invasive Bladder Carcinoma: A Review of Clinical Utility [Internet].

According to Canadian Cancer Statistics, bladder cancer is the fifth most common cancer, accounting for more than 4% of all cancers or 7,800 cases per year. Of all incidents of bladder cancer cases at first diagnosis, about 80% were non-muscle invasive bladder cancer (NMIBC) and 20% were muscle invasive and advanced bladder cancer. Smoking is the main risk factor of bladder cancer., Other risk factors include exposure to chemicals such as aromatic compounds, radiation and chemotherapy., The most common symptom of bladder cancer is the presence of blood in the urine. Bladder cancer is diagnosed by means of cystoscopy and transurethral resection of the bladder tumor (TURBT) in combination with urine analysis and cytology., The tumors are classified based on the degree of invasion into layers of tissues; CIS (flat on surface or carcinoma in situ), Ta (raspberry growth on surface), and T1 (moves into submucosa layer) are those not yet invading into the muscle or NMIBC, while T2a, T2b, T3b and T4a are those invade deeper into the muscle layer and perivesical fat tissue. About 60% of NMIBC are Ta type, while CIS and T1 account for 10% and 30%, respectively. After the initial removal of NMIBC by TURBT, tumors can come back (recurrence) or come back and invade into the muscle layer (progression). Tumors are graded based on the risk of progression and metastasis. For instance, Ta tumors are usually low grade (non-aggressive) but have high risk of recurrence and just require repeated scraping, while CIS and T1 tumors are high grade (aggressive), have a high risk of progression to muscle layer and require more aggressive treatment.

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