I do not know enough to tell which one to choose, but I have noticed urologists use cytology first and if the answer is not clear such as Atypical or suspicious for high grade urothelial carcinoma the urologist uses biomarker based urine analysis to confirm the result of cytology.
Cytology
Cytology test is based upon a cytopathologist examining dead or live cells in urine which were fallen from the bladder wall.
In 2013, the international cytoplathologists group published the new guidelines to improve the accuracy for cytology report and came up with 7 classifications (The Paris System). The professor of Yale School of Medicine gave a webinar and the risk of malignancy of each classification based upon Yale's experience. Notice if the cytology report says High Grade urothelial carcinoma, 90% were found with cancer. Also, if cytopathology report says Negative for UHUC, 90% chance that there are no UGHC. So I feel confident that I can use to check if I have HG bladder cancer or not.
Unsatisfactory/nondiagnostic <5-10%
Negative for HGUC 0-10%
Atypical urothelial cells 8-35%
Suspicious for HGUC 50-90%
Low-grade urothelial neoplasm ~10%
High-grade urothelial carcinoma >90%
Other malignancy >90%
Epicheck
Epicheck is biomarkers based urine test. Epicheck checks changes in DNA methylation in proprietary 15 different genes which have been implicated for causing bladder cancer. Because it is proprietary, I do not know what 15 genes are, but those genes are either tumor promoter genes and tumor suppressor genes. Tumor promoter genes produce proteins which promote cancer, for example the protein which signals the cell to divide. Tumor suppressor genes produces proteins which prevents from a cell to become cancer. For example there are tumor suppressor proteins which will repair if DNA has errors during DNA replication. DNA methylation disables genes to produce proteins. So, if there are DNA methylations for a tumor suppressor gene, the tumor suppressor protein is not produced, so DNA errors will not be corrected during the cell division, which leads to producing cancer cells. Or, if DNA methylations are missing for Tumor promoter genes, tumor promoter protein will be produced, e.g. the protein to signal dell division to be produced, thus causing the cell to divide constantly. There have been several studies associating DNA methylations to specific genes associated with bladder cancer. Epicheck utilized finding from those studies to have come up with 15 different genes.
Below table shows cytology and other urine analysis available in the market. If you scroll the bottom of the table, Sensitivity and Selectivity will be shown. Different urine analysis tool uses different methods.
One good feature of Epicheck is that the accuracy does not depend upon the experience of the analyst compare to cytology of which the accuracy depends upon the experience of the pathologist.