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REVIEW

Bladder Cancer Biomarkers: Recent Advances in Early Detection, Treatment Prediction, and Prognosis

Ziyou Bai1,2,#, Xiaoyan Song3,#, Jiayin Sun1,2,#, Wen Xiao1,2,*, Xiangui Meng1,2,*, Wei Dong1,2,*
1 Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
2 Institute of Urology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
3 Department of Ultrasound, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
* Corresponding Author: Wen Xiao. Email: email; Xiangui Meng. Email: email; Wei Dong. Email: email
# These authors contributed equally to this work as co-first authors

Oncology Research https://doi.org/10.32604/or.2026.086230

Received 26 May 2026; Accepted 06 August 2026; Published online 10 August 2026

Abstract

Bladder cancer (BC) is a prevalent malignancy characterized by a high recurrence rate and the necessity for long-term surveillance demands, creating a need for accurate yet practical tools for early detection and monitoring. While current standards including cystoscopy, urinary cytology, and imaging remain indispensable, their clinical utility is constrained by invasiveness, suboptimal sensitivity for selected lesions or low-grade lesions, inter-observer variability, and cumulative costs. Currently, biomarker research has expanded from single protein assays to multi-analyte strategies encompassing DNA, RNA, proteins, extracellular vesicle-associated cargo, and metabolomics signatures. This review synthesizes recent advances in diagnostic, surveillance, prognostic, and treatment-predictive biomarkers, with emphasis on assay principles, analytical platforms and reported performance where available. Furthermore, we delineate critical barriers to translation, including limited prospective multicenter validation, heterogeneous pre-analytical workflows, inconsistent thresholds, and the persistent trade-off between sensitivity and specificity in real-world benign urologic conditions. Ultimately, while emerging biomarkers and multi-omics panels hold transformative potential as non-invasive adjuncts in risk-adapted clinical pathways, their routine adoption is contingent upon rigorous clinical integration and standardized validation.

Keywords

Bladder cancer; biomarker; translational urology; liquid biopsy

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