A possible urine test could predict bladder cancer up to a decade before other clinical signs appear, a new research project suggests. While it still needs to be verified in additional tests involving larger numbers of patients, this discovery could be a breakthrough when it comes to non-invasively spotting a disease that can be challenging to identify in its early stages.

The potential breakthrough involves a biomarker found by researchers from the International Agency for Research on Cancer (IARC) in collaboration with a variety of international research partners. They showed that bladder cancer mutations in a specific gene can be detected in the urine of individuals up to 10 years before clinical diagnosis of the disease. This opens up the possibility of scientists creating a simple, publicly available urine DNA test that could act as a low-cost, non-invasive screening tool to alert potential patients to the onset of bladder cancer.

The innovative test developed by the researchers is based on the detection of mutations in the telomerase reverse transcriptase (TERT) gene. The researchers analyzed urine samples that were collected up to 10 years before clinical diagnosis from 38 otherwise asymptomatic individuals who later developed bladder cancer, along with 152 cancer-free control samples.

They found that the the TERT promoter mutations could be detected a decade prior to clinical diagnosis in 46.7% of the asymptomatic individuals who later developed the disease. More importantly, they found that the mutations occurred in zero of the matched control samples. While that still leaves room for error, it’s nonetheless promising as grounds upon which to proceed with later tests and research.

“Our results provide the first evidence from a population-based prospective cohort study of the potential of urinary TERT promoter mutations as promising non-invasive biomarkers for early detection of [bladder cancer],” the researchers write in an abstract describing their work. “Further studies should validate this finding and assess their clinical utility in other longitudinal cohorts.”

A paper describing the work, titled “Urinary TERT promoter mutations are detectable up to 10 years prior to clinical diagnosis of bladder cancer: Evidence from the Golestan Cohort Study,” was recently published in the journal EbioMedicine.