Hematuria as a Marker of Occult Urinary Tract Cancer

Nielsen, Matthew; Qaseem, Amir

doi:10.7326/l16-0328

Cited by 2 publications

(2 citation statements)

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“…Hence, intense surveillance such as CT urography and cystoscopy might be omitted for those younger cohorts and ultrasonography or unenhanced CT would be useful to identify stones, UTI, and gross malignant tumors. 13 However, patients with persistent or repeated hematuria should be more thoroughly tested.…”

Section: Strategy For Hematuriamentioning

confidence: 99%

“…6 The scope of application and the choice of these detailed examinations vary depending on the guidelines. 4,[7][8][9][10][11][12][13] The American Urological Association (AUA) guidelines on microhematuria has the widest scope of application for detailed examinations and recommends cystoscopy and CT urography for patients at risk of malignant tumors, such as those aged 35 years and older, men, and smokers. 4 Although accurate detection of malignant tumors is desired for the work-up of patients with hematuria, an optimal examination corresponding to the risk of malignant tumor should be chosen not to expose patients without malignancy to unnecessary hazards.…”

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Cancer Prevalence and Risk Stratification in Adults Presenting With Hematuria: A Population-Based Cohort Study

Takeuchi

McDonald

Takahashi

et al. 2021

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Objective: To calculate the prevalence of renal cell carcinoma (RCC), upper urinary tract urothelial carcinoma (UT-UC), and lower urinary tract urothelial carcinoma (LT-UC) in patients with gross asymptomatic microhematuria (AMH) and symptomatic microhematuria (SMH). Patients and Methods: This study was a population-based retrospective descriptive study. The study was approved by both the Mayo Clinic Institutional Review Board and the Olmsted Medical Center Institutional Review Board, and the population used was Olmsted County residents. A total of 4453 patients who presented with an initial episode of hematuria from January 1, 2000, through December 30, 2010, were included. Of the 4453 patients (median age, 58 years; interquartile range, 44.6-73.3 years), 1487 (33.4%) had gross hematuria, 2305 (51.8%) had AMH, and 661 (14.8%) had SMH. Results: In the 1487 patients with gross hematuria, the prevalence of RCC, UT-UC, and LT-UC was 1.3%, 0.8%, and 9.0%, respectively. In the 2305 patients with AMH, the prevalence of RCC, UT-UC, and LT-UC was 0.2%, 0.3%, and 1.6%, respectively. In the 661 patients with SMH, the prevalence of RCC, UT-UC, and LT-UC was 0.6%, 0.2%, and 0.3%, respectively. Age was the most relevant risk factor for any hematuria type. Conclusion: This unique cohort study reported that the prevalence of RCC or UC in patients with AMH and SMH was low, especially in the young cohort, and a large number of intense work-ups, such as cystoscopy and computed tomography urography, currently conducted could be omitted if stratified by hematuria type and age.

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Section: Strategy For Hematuriamentioning

confidence: 99%

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confidence: 99%

Cancer Prevalence and Risk Stratification in Adults Presenting With Hematuria: A Population-Based Cohort Study

Takeuchi

McDonald

Takahashi

et al. 2021

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Guideline of guidelines: asymptomatic microscopic haematuria

et al. 2017

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The aim of the present study was to review major organizational guidelines on the evaluation and management of asymptomatic microscopic haematuria (AMH). We reviewed the haematuria guidelines from: the American Urological Association; the consensus statement by the Canadian Urological Association, Canadian Urologic Oncology Group and Bladder Cancer Canada; the American College of Physicians; the Joint Consensus Statement of the Renal Association and British Association of Urological Surgeons; and the National Institute for Health and Care Excellence. All guidelines reviewed recommend evaluation for AMH in the absence of potential benign aetiologies, with the evaluation including cystoscopy and upper urinary tract imaging. Existing guidelines vary in their definition of AMH (role of urine dipstick vs urine microscopy), the age threshold for recommending evaluation, and the optimal imaging method (computed tomography vs ultrasonography). Of the reviewed guidelines, none recommended the use of urine cytology or urine markers during the initial AMH evaluation. Patients should have ongoing follow-up after a negative initial AMH evaluation. Significant variation exists among current guidelines for AMH with respect to who should be evaluated and in what manner. Given the patient and health system implications of balancing appropriately focused and effective diagnostic evaluation, AMH represents a valuable future research opportunity.

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Hematuria as a Marker of Occult Urinary Tract Cancer

Cited by 2 publications

References 0 publications

Cancer Prevalence and Risk Stratification in Adults Presenting With Hematuria: A Population-Based Cohort Study

Cancer Prevalence and Risk Stratification in Adults Presenting With Hematuria: A Population-Based Cohort Study

Guideline of guidelines: asymptomatic microscopic haematuria

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