Perspective on the use of optics in bladder cancer detection and diagnosis.

Significance: Bladder cancer (BC) diagnosis, management, and outcomes depend on the accurate detection of tumors via optical technologies. Accordingly, understanding the benefits and limitations of these technologies permits improvements in patient care and identifies areas for future research. Aim: We outline the current process of BC detection and diagnosis, explore the current role of optical technologies, and discuss the opportunities and challenges they present in this field. Approach: The current diagnostic pathway of BC, the use of optical technologies, and their shortcomings in this process are reviewed. From there, opportunities and challenges of optics in BC detection and diagnosis are discussed. Results: BC management is expensive due to the limitations of white light cystoscopy, the requirement for histopathological confirmation, and the need for long-term surveillance. Alternative non-optical methods lack accuracy, and available optical techniques focus only on cancer detection. Alternatives to histopathology need to provide accurate real-time results to be effective. Optical advancements offer potential benefits; however, challenges include cost-effectiveness, device complexity, required training, and tumor heterogeneity. Conclusions: Optical techniques could accelerate BC diagnosis, reduce costs, and enable alternative treatments. However, overcoming technical and practical challenges is essential for their successful integration.