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To the Editor: In their article on detection of bladder cancer using a proteomic assay,¹ Dr Grossman and colleagues do not specify why the studied patients underwent cystoscopy. It is necessary to understand the study population to judge validity and generalizability. In particular, it would be important to know what percentage of the patients had symptoms or signs, how many had occupational exposure, and how many were screened solely because they were smokers. Given the absence of standard screening recommendations based on smoking status, if this were the basis for testing in some of these subjects I would want to know if it was because of current or past smoking, or whether it was based on amount smoked per day.

The test characteristics of the nuclear matrix protein 22 (NMP22) assay in this population were not particularly good. A relatively low positive predictive value (37% in the study patients at . . . [Full Text of this Article]

Donald B. Louria, MD
louriado@umdnj.edu
Department of Preventive Medicine
University of Medicine and Dentistry of New Jersey–NJ Medical School
Newark

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