Yes, there are several alternatives to the NMP22 test for diagnosing bladder cancer. These include urine cytology, cystoscopy, and other urine-based tests such as the UroVysion test and the BTA (Bladder Tumor Antigen) test. Each of these tests has its own advantages and limitations, and the choice of test may depend on factors such as patient history, symptoms, and the availability of testing methods.