Featured Research

from universities, journals, and other organizations

Microscopic blood in urine unreliable indicator of urinary tract cancer

Date:
January 9, 2013
Source:
Elsevier
Summary:
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 study 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.

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.

Related Articles


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."


Story Source:

The above story is based on materials provided by Elsevier. Note: Materials may be edited for content and length.


Journal Reference:

  1. Ronald K. Loo, MD; Stephen F. Lieberman, MD; Jeff M. Slezak, MS; Howard M. Landa, MD; Albert J. Mariani, MD; Gary Nicolaisen, MD; Ann M. Aspera, MD; and Steven J. Jacobsen, MD, PhD. Stratifying Risk of Urinary Tract Malignant Tumors in Patients with Asymptomatic Microscopic Hematuria. Mayo Clinic Proceedings, February 2013

Cite This Page:

Elsevier. "Microscopic blood in urine unreliable indicator of urinary tract cancer." ScienceDaily. ScienceDaily, 9 January 2013. <www.sciencedaily.com/releases/2013/01/130109151206.htm>.
Elsevier. (2013, January 9). Microscopic blood in urine unreliable indicator of urinary tract cancer. ScienceDaily. Retrieved November 26, 2014 from www.sciencedaily.com/releases/2013/01/130109151206.htm
Elsevier. "Microscopic blood in urine unreliable indicator of urinary tract cancer." ScienceDaily. www.sciencedaily.com/releases/2013/01/130109151206.htm (accessed November 26, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, November 26, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Pet Dogs to Be Used in Anti-Ageing Trial

Pet Dogs to Be Used in Anti-Ageing Trial

Reuters - Innovations Video Online (Nov. 26, 2014) Researchers in the United States are preparing to discover whether a drug commonly used in human organ transplants can extend the lifespan and health quality of pet dogs. Video provided by Reuters
Powered by NewsLook.com
Today's Prostheses Are More Capable Than Ever

Today's Prostheses Are More Capable Than Ever

Newsy (Nov. 26, 2014) Advances in prosthetics are making replacement body parts stronger and more lifelike than they’ve ever been. Video provided by Newsy
Powered by NewsLook.com
From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins