Background: The American Cancer Society estimates that 73,000 new bladder cancers will be detected this year and 15,000 victims will die of their disease. While those numbers pale in comparison to Lung, Breast and Prostate, the reality is that 500,000 bladder cancer survivors require regular surveillance to detect recurrence or new tumors in their bladder or upper collecting tracts. This reality makes bladder cancer the most expensive cancer per individual patient because of the invasive nature of the management tools. With the guidance of our urology colleagues, the current goal of examining urinary tract specimens is to identify those patients whose urothelium has undergone neoplastic transformation of a high grade. Patients are either high risk for high grade urothelial carcinoma (HGUC) because of environmental factors, or because they have already been treated for a HGUC and are under surveillance for another HGUC. The most vital discovery would be a non-invasive diagnostic tool with a high specificity and sensitivity. Currently, urinary cytology still remains the best we have, with a high specificity, but only a modest sensitivity, especially if all grades of tumors are included in the calculations.
We invite your participation in this collaborative process by responding to surveys related to each category. These responses will be tallied with your critical comments and used to guide each of the groups in their deliberation. The final work product will be an atlas published by Springer, similar to the two Bethesda Atlases for Gynecologic and Thyroid cytology. The major difference will be that the diagnostic criteria will be evidence based and tested for reproducibility. Thank you for joining us in this grass roots collaboration, initiated by cytology professionals, not by any government agency or industrial enterprise.