Navigation Links
Microscopic blood in urine unreliable indicator of urinary tract cancer
Date:1/9/2013

Rochester, MN, January 9, 2013 Microscopic amounts of blood in urine have been considered a risk factor for urinary tract malignant tumors. However, only a small proportion of patients referred for investigation are subsequently found to have cancer. A new Kaiser Permanente Southern California study published in the February Mayo Clinic Proceedings reports on the development and testing of a Hematuria Risk Index to predict cancer risk. This could potentially lead to significant reductions in the number of unnecessary evaluations.

Individuals with microscopic hematuria (three or more red blood cells per high-power field on a recent urine analysis) are currently referred for follow-up radiologic and invasive examinations, even when they are asymptomatic. American Urological Association (AUA) best practice policy recommendations include urine testing and abdominal computed tomography (CT) or intravenous pyelography plus renal ultrasonography. Patients may also undergo cystoscopy, a procedure that involves passing a narrow tube fitted with a miniature camera into the bladder to closely examine both the bladder and urethra.

In an earlier study, researchers had found that the AUA practice recommendations did not perform well in identifying which patients were most likely to have malignant tumors, suggesting that there might be alternative criteria that better identify patients who truly require further evaluation. Subsequently the team of investigators conducted a prospective cohort study of patients over a two-year period in an integrated care organization in three regions along the West Coast of the United States. They identified both a test cohort and a validation cohort of patients with hematuria evaluations and followed the patients passively through their electronic health records for a diagnosis of urothelial or renal cancer. The degree of microscopic hematuria, history of gross hematuria, smoking history, age, race, imaging findings, and cystoscopy findings were evaluated as risk factors for malignant tumors.

The test cohort consisted of 2630 patients, of whom 55 (2.1%) had a neoplasm detected and 50 (1.9%) had a pathologically confirmed urinary tract cancer. The strongest predictors of cancer were age of 50 years or older and a recent diagnosis of gross hematuria. Male sex was also predictive of cancer, whereas smoking history and 25 or more red blood cells per high-power field on a recent urinalysis were not statistically significant.

The findings were used to create a Hematuria Risk Index to predict cancer risk and performed comparably in the validation cohort of 1784 patients. Overall, 32% of the population was identified as low risk and 0.2% had a cancer detected; 14% of the population was identified as high risk, of whom 11.1% had a cancer found.

"These data confirm that a large number of follow-up examinations could be safely avoided," observes senior investigator Steven J. Jacobsen, MD, PhD, Kaiser Permanente Southern California, Pasadena, California. "They suggest that microscopic hematuria is an unreliable indicator of urinary tract malignant tumors. Patients with microscopic hematuria younger than 50 years and with no history of gross hematuria may not benefit from further evaluation and therefore could avoid unnecessary risk from radiation exposure and invasive endoscopy. These findings may be used to simplify referral guidelines for evaluation in asymptomatic patients with microscopic hematuria and reduce the number of unnecessary evaluations."


'/>"/>

Contact: Rachael Zaleski
mcpmedia@elsevier.com
215-239-3658
Elsevier Health Sciences
Source:Eurekalert

Related medicine news :

1. Spaceflight may extend the lifespan of microscopic worm
2. Researchers will employ microscopic clay minerals to design more efficient and less toxic drugs
3. US Drug Watchdog Now Urges All Recipients Of A All Metal Hip Implant to Get A Blood Test Out of New Concerns About Side Effects and They Name Law Firms To Help Victims
4. ARUP Laboratories Introduces Blood Test to Aid in the Early Detection of Lung Cancer
5. U-M sibling study discovers genetic region linked to control of key blood-clotting protein
6. US Drug Watchdog Now Urges a Blood Test for All DePuy Pinnacle Hip Implant Recipients and They Suggest Law Firms to Help Victims of a Failure Get Compensated
7. Common Blood Pressure Drugs Might Lower Dementia Risk
8. Low Wages Linked to Raised Risk for High Blood Pressure
9. US Drug Watchdog Now Urges All Zimmer Stryker, Biomet, Wright and DePuy All Metal Hip Implant Recipients to Get A Blood Test For A Failure-Don't Get Left Holding the Bag
10. US Drug Watchdog will Expand Their Initiative Focused on Helping Recipients of a Failed DePuy Pinnacle All Metal Hip Implant with a New Emphasis on Blood Testing in 2013
11. Rock River Valley Blood Center Announces January is National Blood Donor Month
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2016)... ... , ... Despite last week’s media reports hinting at a June rate hike ... March 2017 for an interest rate increase, according to Rajeev Dhawan of the Economic ... Federal Open Market Committee (FOMC) dot charts are of interest to the press for ...
(Date:5/26/2016)... Hampshire (PRWEB) , ... May 26, 2016 , ... ... care products, has been honored with a 2016 When Work Works Award for its ... award, part of the national When Work Works project administered by the Families and ...
(Date:5/26/2016)... , ... May 26, 2016 , ... ... clinical outcomes, hosted members and suppliers for its inaugural Member Conference at the ... their mission of elevating the operational health of America’s healthcare providers. , The ...
(Date:5/26/2016)... ... 2016 , ... Connor Sports, through its Connor Cares initiative, will ... Tamika Catchings Legacy Tour that will commemorate the Indiana Fever legend’s hall-of-fame career ... all forms and levels of the game, Connor Sports has committed to a significantly ...
(Date:5/26/2016)... ... , ... The Woodlands at John Knox Village , Florida’s first Life ... living and healing, celebrated its grand opening, today. The Woodlands at John Knox Village ... Empowered Staff. , “This is an incredibly fulfilling time for John Knox Village as ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... , May 25, 2016  Granger Diagnostics today ... test for wounds and infections. This test ensures ... and select viruses. The test requires only a ... David G. Bostwick , MD, ... to facilitate wound healing: "We are excited to ...
(Date:5/25/2016)... , May 25, 2016 ... the precision of circulating tumour DNA (ctDNA) analysis ... the appointment of Professor Clive Morris ... leadership across the clinical development programme, scientific collaborations, ... help deliver significant improvements in clinical outcomes for ...
(Date:5/24/2016)... -- Cirujanos holandeses han puesto en marcha ... a compartir sus mejores prácticas por el mundo y ... de Europa, África, Asia y ... que combina la transmisión en vivo con mensajería instantánea ... Educación   "Imagine un médico de Medicines sans ...
Breaking Medicine Technology: