Simple Urine Test Assesses Risk of Kidney Cancer Recurrence at Early Stage

Kidney cancer affects about 400,000 people globally each year, with clear cell renal cell carcinoma being the most common form. Around 20% of patients who undergo curative surgery relapse within five years, requiring frequent CT scans to check for recurrence. These scans expose patients to radiation, cause anxiety, and add costs. Now, a new international study has shown that a simple urine test can reduce the need for half of these scans while still detecting recurrence early.

The study, led by Lund University (Lund, Sweden) and conducted in collaboration with 23 hospitals across ten countries, investigated a diagnostic test based on glycosaminoglycans, or sugar molecules, found in urine. This biomarker panel, called the GAGome test, evaluates the molecular composition of urine to assess cancer recurrence risk. Unlike relying on a single molecule, the test uses a set of biomarkers to provide a stronger diagnostic foundation.

The study followed 134 patients who had undergone curative surgery for kidney cancer, combining regular scans with urine testing. Results showed that the GAGome test detected recurrence in 90% of relapsed patients and correctly identified 97% of those without relapse when results were negative. The findings, published in European Urology Oncology, demonstrated the test’s high sensitivity and reliability in clinical monitoring.

The urine test offers significant advantages over scans alone, which can capture small, uncertain changes that lead to repeated imaging. By incorporating urine tests, clinicians can reduce unnecessary scans, ease patient anxiety, and identify recurrence earlier. The approach could lower healthcare costs while providing safer, more effective follow-up care. Researchers are continuing the study with additional participants to confirm the results by the end of 2025.

“A scan often captures small changes that are not large enough for taking a tissue sample, and therefore, we don’t know if they are signs that the cancer has returned. Our only option is then to carry out more frequent scans, which cause anxiety for the patients and often have little benefit. Using urine tests enables us to better assess the risk, offer more effective checks and potentially halve the number of scans,” said Saeed Dabestani, Associate Professor at Lund University and senior urology consultant at Kristianstad Central Hospital.

“The GAGome test is based on a set of biomarkers, rather than just one molecule, which provides a more robust foundation for making decisions about treatment,” said Saeed Dabestani, associate professor at Lund University who led the study. “If the test comes back negative, we are more or less certain that there is no recurrence, but if the test is positive, we must continue to investigate.”