Assessment and management of non-visible haematuria in primary care

Non-visible versus visible haematuria and bladder cancer risk: a study of electronic records in primary care

“…18 The annual incidence of non-visible haematuria in controls in this current study was 0.3%. This is lower than the reported prevalence in the UK adult male population of 2.5%, 10 and may be explained, in part, by few UK patients having routine urinalysis.…”

“…9 Alternatively, it may be detected only on examination of urine, most commonly as a positive urinalysis test for blood (chemical dipstick), or as more than a set number of red cells per high-power field on microscopy, or in a Coulter counter. 10 Under these circumstances, it is called 'non-visible', 'invisible', or 'microscopic' haematuria. Isolated non-visible haematuria is defined as three or more red blood cells per highpower field in the absence of infection or proteinuria.…”

“…Therefore, for this and other reasons related to cost and practicality, confirmation of a positive dipstick result by urinary microscopy in primary care is no longer recommended. 10,11 The background rate of asymptomatic non-visible haematuria in UK males is around 2.5%, increasing to 22% in those aged >60 years. 10 Other reports also show higher prevalence with increasing age.…”

“…10,11 The background rate of asymptomatic non-visible haematuria in UK males is around 2.5%, increasing to 22% in those aged >60 years. 10 Other reports also show higher prevalence with increasing age. 11,12 A screening study of annual urinalysis in 1000 healthy Israeli military male recruits, aged 18-33 years at the beginning of the 15-year study, reported 39% with dipstick-positive urinalysis for haematuria at least once and 16% on two or more occasions.…”

Clinical features of bladder cancer in primary care

“…This is the view of NICE guidance and a recent review, but without primary care data to substantiate them. 23,24 A 2003 systematic review of the economics of bladder cancer identified six papers examining the cost-effectiveness of investigation for bladder cancer. 25 In a population with a prevalence of 1% there was an estimated cost of $170 000 per case identified; this figure fell to $12 000 per case if the prevalence were 15%.…”