No randomized controlled bladder cancer screening trials have been conducted in environmentally or industrially exposed cohorts. Completed studies have usually not had comparable control groups, have not been of sufficient sample size to show an effect on outcome, and have been of insufficient length to show a mortality benefit (or lack thereof) for the modality or modalities being assessed.[68,69] One study described the usefulness of measuring three biomarkers in voided urine for risk assessment and cancer detection in a large cohort of Chinese workers at increased risk of bladder cancer. The workers were individually stratified, screened, monitored, and diagnosed on the basis of predefined molecular biomarker profiles. These techniques remain investigational.
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