Answer is C (Urine tumor markers) Urine tumor markers are the single best answer of exclusion as these are neither sensitive nor specific enough to replace cystoscopy and cytology. 'Individuals older than 40 years of age who develop haematuria , should have a urine specimen for cytology and undergo cystoscopy and imaging of the urinary tract with an intravenous prelozram or CT Recommended investigations in individuals greater than 40 years who develop haematuria include: Devita/H16th Urinary cytologyQ for malignant cells Cvstocopy Imaging of the urinary tract with Intravenous Pyelogram or CT scanQ Other urine assay' (tumor markers) have been used to diagnose disease and follow up patients including flow cytometry, blood group antigens (Lewis x), cytokeratins, nuclear matrix proteins, Fibrin degradation products and telomerose. None is sensitive or specific enough to replace cystoscopy and urine cytology. - Devita