Racial Differences in the Detection Rate of Bladder Cancer Using Blue Light Cystoscopy: Insights from a Multicenter Registry

Simple Summary Blue light cystoscopy (BLC) is a technique used to find bladder tumors more effectively. However, its performance across different races remains uncertain. In this study, we looked at how well BLC detects cancer in people of different races. We collected data from patients who had bladder tumor surgeries from 2014 to 2021. Overall, we found that BLC was better at spotting tumors compared to traditional white light cystoscopy (WLC). This was true for most races, especially for Caucasian and Asian patients. When BLC was added to WLC, it increased the detection of cancer by 10%, with the biggest improvement seen in Asian patients. Interestingly, Asian patients had the highest chance of BLC correctly identifying cancer, while Hispanic patients had the best chance of ruling out cancer. This suggests that combining BLC with WLC can improve the detection of bladder cancer irrespective of race.Abstract The use of blue light cystoscopy (BLC) has been shown to improve bladder tumor detection. However, data demonstrating the efficacy of BLC across different races are limited. Herein, we aim to evaluate heterogeneity in the characteristics of BLC for the detection of malignant lesions among various races. Clinicopathologic information was collected from patients enrolled in the multi-institutional Cysview (R) registry (2014-2021) who underwent transurethral resection or biopsy of bladder tumors. Outcome variables included sensitivity and negative and positive predictive values of BLC and white light cystoscopy (WLC) for the detection of malignant lesions among various races. Overall, 2379 separate lesions/tumors were identified from 1292 patients, of whom 1095 (85%) were Caucasian, 96 (7%) were African American, 51 (4%) were Asian, and 50 (4%) were Hispanic. The sensitivity of BLC was higher than that of WLC in the total cohort, as well as in the Caucasian and Asian subgroups. The addition of BLC to WLC increased the detection rate by 10% for any malignant lesion in the total cohort, with the greatest increase in Asian patients (18%). Additionally, the positive predictive value of BLC was highest in Asian patients (94%), while Hispanic patients had the highest negative predictive value (86%). Our study showed that regardless of race, BLC increases the detection of bladder cancer when combined with WLC.