FIG. 15:  Focusing on the intended use of biomarkers, the ideal role for a biomarker is to identify cancer missed by cystoscopy.  It is an adjunct test, so for example if a patient has a normal cystoscopy but a positive biomarker result, a physician will know that there is cancer in that patient. 

The other possible use of biomarkers is to improve detection of cancers in patients with hematuria.  These are patients who are at risk, and therefore we would like to know whether or not they have cancer and whether or not they need further evaluation.