▲Professor In Gab Jeong of the Department of Urology at Asan Medical Center is explaining bladder cancer diagnostic methods, such as urinary DNA methylation tests, to the patient. 

While cystoscopy is the standard method for early diagnosis of bladder cancer, its downsides include high cost and extreme pain, especially for adult males. Other auxiliary tests have not been widely used due to low accuracy. However, a team led by Professor In Gab Jeong of the Department of Urology at Asan Medical Center recently published a study showing that DNA testing using urine samples provides highly accurate bladder cancer diagnosis.

The research team used 20ml of naturally voided urine samples collected from 1,099 patients scheduled for cystoscopy due to microscopic or gross hematuria symptoms at 10 medical institutions in South Korea from March 2022 to May 2024. They compared and analyzed the urinary DNA methylation test and conventional auxiliary tests. Urinary DNA methylation testing detects cancer cells by analyzing methylation pattern changes, a key mechanism for gene activity regulation.

Among 1,099 hematuria patients, 219 were diagnosed with bladder cancer, of whom 176 were identified as high-risk bladder cancer patients with a greater likelihood of recurrence or metastasis. The urinary DNA methylation test showed a sensitivity of 89.2% in high-risk bladder cancer detection. The sensitivity of NMP22 test, a conventional auxiliary test, and urine cytology test was 51.5% and 39.7%, respectively, confirming better patient screening accuracy of the urinary DNA methylation test. Additionally, the specificity was measured at 87.8% for the urinary DNA methylation test, 91.6% for NMP22 test, and 99.5% for the urine cytology test. Specificity refers to the probability of correctly diagnosing the absence of a disease in people without a disease.

The research findings were recently published in the international journal ‘JAMA Oncology.’