Researchers say the noninvasive test could help doctors prioritize high-risk patients and reduce unnecessary urgent cystoscopies
BIRMINGHAM, England (Midtown Times) — A DNA-based urine test detected more than 92% of bladder cancers in a study involving nearly 1,000 patients, raising hopes that doctors could identify high-risk cases sooner while sparing some patients from immediate invasive examinations.
The GALEAS Bladder test correctly identified 71 of the 77 cancers diagnosed among 964 patients referred for urgent investigation at seven National Health Service urology departments in England and Scotland.
Most notably, the test detected all 17 cases of muscle-invasive bladder cancer—the most serious form identified during the study—and 35 of 36 high-grade cancers.
A negative result was associated with a 99.3% probability that the patient did not have bladder cancer within the population studied. Among patients whose blood in the urine was detectable only through testing rather than visible to the eye, GALEAS identified every cancer diagnosed during the study.
The peer-reviewed findings were published in European Urology Oncology. The prospective observational study was conducted between October 2024 and June 2025 and led by researchers at the University of Birmingham in collaboration with Nonacus, the diagnostic company that developed the commercial test. The University of Birmingham reported an overall sensitivity and specificity of approximately 92%.
How the test works
GALEAS examines DNA released into a patient’s urine, searching for mutations across 23 genes associated with bladder cancer. A sample can be collected without an invasive hospital procedure and analyzed at a laboratory, with results generally available within five to 10 working days after receipt.
Researchers believe the test could be used to determine which patients require the fastest access to cystoscopy, the principal procedure used to examine the bladder for cancer.
During a cystoscopy, a clinician passes a thin tube equipped with a camera through the urethra and into the bladder. Although the examination remains an important diagnostic tool, it can cause discomfort and requires hospital staff, equipment and appointment time.
More than 300,000 cystoscopies are performed annually in the United Kingdom, placing pressure on urology departments and contributing to waiting lists.
Could reduce urgent procedures
Only about 8% of patients enrolled in the study were ultimately diagnosed with bladder cancer. Nevertheless, all had entered an urgent diagnostic pathway because blood had been detected in their urine.
Researchers calculated that using GALEAS as a preliminary triage tool could result in approximately 730 fewer urgent cystoscopies for every 1,000 patients assessed. That figure is a statistical estimate rather than a measured reduction in procedures during the trial.
The test would not eliminate cystoscopy or replace the tissue examinations required to confirm a cancer diagnosis. Instead, a positive result could help clinicians move higher-risk patients to the front of the line, while some people with negative results could safely have their cystoscopy deferred when medically appropriate.
The study was funded by Nonacus, and several researchers involved in the work are connected to the company. Additional evaluation will be important to confirm how the test performs across broader patient populations and how safely it can be incorporated into routine diagnostic care.
Blood in urine should still be investigated
Blood in the urine, known medically as hematuria, is the most common warning sign of bladder cancer. It may appear pink, red or dark brown and can occur only once or intermittently.
The symptom does not necessarily indicate cancer and can also be caused by infections, kidney stones and other medical conditions. However, health authorities advise patients to seek medical evaluation even when the amount of blood is small or no other symptoms are present. The NHS emphasizes that early investigation can make cancer easier to treat when it is present.
Researchers said the latest findings demonstrate the potential of molecular urine testing to make bladder-cancer assessment faster, more convenient and less invasive. The immediate goal is not to abandon cystoscopy, but to use it more efficiently while reducing delays for patients most likely to have cancer.
