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In most cases, multiple tests will be used to diagnose bladder cancer. After taking a complete medical history and performing a physical exam, your healthcare professional may order:
Urinalysis. This simple urine test looks for blood in the urine. Blood in the urine doesn't always indicate bladder cancer; however, it can be an early sign of the disease.
Urine cytology. Urine samples are analyzed under a microscope for the presence of cancer cells.
Cytoscopy. Considered the gold standard in diagnosis, cystoscopy involves inserting a long, thin tube equipped with a camera into the bladder to look for any abnormalities. Any suspicious areas or growths may be biopsied or removed and taken for lab analysis; a computed tomography (CT) scan may also be performed to check for problems in the bladder and surrounding organs. Pieces of the tumor are then removed through a procedure called transurethral bladder tumor resection, or TURBT.
Newer tests that look for certain cancer-associated substances in urine are available (for example, UroVysion, BTA tests, Immunocyt and NMP22 BladderCheck); these are typically only used in people who either already have symptoms of bladder cancer or to check for cancer recurrence following treatment.