Urological recommendations from the National Institute for Health and Care Excellence (NICE) Guideline, June 2015: Suspected cancer: recognition and referral

Guideline of guidelines: asymptomatic microscopic haematuria

“…In the following section, we review the guidelines that have been most recently updated . A more complete comparison, including all guidelines identified, is provided in Table .…”

“…The use of urine cytology or urine markers (e.g. NMP22, BTA‐stat, UroVysion FISH) in the initial evaluation of patients with AMH is not recommended by any of the reviewed guideline statements as they lack demonstrable efficacy , and may lead to emotional stress and unnecessary biopsies in the case of false‐positive results . The AUA guidelines do note that urine cytology may be useful in cases of persistent AMH after negative evaluation or those with risk factors for carcinoma in situ , while the Canadian Consensus Statement recommends cytology only for those with visible or symptomatic microscopic haematuria .…”

“…In the following section, we review the guidelines that have been most recently updated [4][5][6][7][8][9][14][15][16]. A more complete comparison, including all guidelines identified, is provided in Table 1 [4,5,7,8,[10][11][12][13]16]. We evaluate recommendations with regard to the diagnosis of AMH including a review of specific scenarios that may warrant inclusion or exclusion from AMH evaluation, the recommended evaluation for those with AMH, and the follow-up of patients after a negative evaluation.…”

“…A number of national organizations and specialty societies have released guidelines for the diagnosis and evaluation of haematuria . Notably, while visible haematuria is recognized as a symptom that should prompt urological referral for evaluation , the recommended investigation of microscopic haematuria, and in particular asymptomatic microscopic haematuria (AMH) is inconsistent among the available guidelines. Indeed, in Sweden, testing for microscopic haematuria was abandoned in 1999 .…”

“…The importance of the finding of haematuria is secondary to the potential underlying risk of clinically significant pathology, including malignancy, urolithiasis and medical renal disease [2,3]. A number of national organizations and specialty societies have released guidelines for the diagnosis and evaluation of haematuria [4][5][6][7][8][9][10][11][12][13][14][15][16]. Notably, while visible haematuria is recognized as a symptom that should prompt urological referral for evaluation [4][5][6][7][8][9][10][11][12][13][14][15][16], the recommended investigation of microscopic haematuria, and in particular asymptomatic microscopic haematuria (AMH) is inconsistent among the available guidelines.…”