Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In their study of the relevance of urine telomerase for bladder cancer detection, Dr Sanchini and colleagues1 report that the TRAP assay was accurate in discriminating men with bladder cancer from healthy age-matched controls.
In previous studies, the suitability of the TRAP assay has been hampered by its widely varying sensitivity, presumably due to the instability of telomerase activity in urine.2 Sanchini et al1 did not encounter these problems, but they describe that about 7% of study participants had insufficient material for cytology, and 23% of cancer patients bypassed cytology examination. Thus, not all participants received the same reference standard, and the study design must therefore be regarded as suboptimal.3
Weikert S, Christoph F, Miller K. Urine Telomerase and Bladder Cancer Detection. JAMA. 2006;295(9):998-999. doi:10.1001/jama.295.9.998-b