Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged >= 16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15; P < 0.001), male sex 1.30 (95% CI 1.14-1.50; P < 0.001), and smoking 2.70 (95% CI 2.30-3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer.

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study / Khadhouri, Sinan; Gallagher, Kevin M; MacKenzie, Kenneth R; Shah, Taimur T; Gao, Chuanyu; Moore, Sacha; Zimmermann, Eleanor F; Edison, Eric; Jefferies, Matthew; Nambiar, Arjun; Mannas, Miles P; Lee, Taeweon; Marra, Giancarlo; Lillaz, Beatrice; Gómez Rivas, Juan; Olivier, Jonathan; Assmus, Mark A; Uçar, Taha; Claps, Francesco; Boltri, Matteo; Burnhope, Tara; Nkwam, Nkwam; Tanasescu, George; Boxall, Nicholas E; Downey, Alison P; Lal, Asim A; Antón-Juanilla, Marta; Clarke, Holly; Lau, David H W; Gillams, Kathryn; Crockett, Matthew; Nielsen, Matthew; Takwoingi, Yemisi; Chuchu, Naomi; O'Rourke, John; MacLennan, Graeme; McGrath, John S; Kasivisvanathan, Veeru. - In: BJU INTERNATIONAL. - ISSN 1464-4096. - ELETTRONICO. - 128:(2021), pp. 440-450. [10.1111/bju.15483]

The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study

O'Rourke, John;
2021

Abstract

Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged >= 16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15; P < 0.001), male sex 1.30 (95% CI 1.14-1.50; P < 0.001), and smoking 2.70 (95% CI 2.30-3.18; P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer.
2021
128
440
450
Khadhouri, Sinan; Gallagher, Kevin M; MacKenzie, Kenneth R; Shah, Taimur T; Gao, Chuanyu; Moore, Sacha; Zimmermann, Eleanor F; Edison, Eric; Jefferies, Matthew; Nambiar, Arjun; Mannas, Miles P; Lee, Taeweon; Marra, Giancarlo; Lillaz, Beatrice; Gómez Rivas, Juan; Olivier, Jonathan; Assmus, Mark A; Uçar, Taha; Claps, Francesco; Boltri, Matteo; Burnhope, Tara; Nkwam, Nkwam; Tanasescu, George; Boxall, Nicholas E; Downey, Alison P; Lal, Asim A; Antón-Juanilla, Marta; Clarke, Holly; Lau, David H W; Gillams, Kathryn; Crockett, Matthew; Nielsen, Matthew; Takwoingi, Yemisi; Chuchu, Naomi; O'Rourke, John; MacLennan, Graeme; McGrath, John S; Kasivisvanathan, Veeru
File in questo prodotto:
File Dimensione Formato  
bju.15483.pdf

Accesso chiuso

Descrizione: full text
Tipologia: Pdf editoriale (Version of record)
Licenza: Tutti i diritti riservati
Dimensione 1.14 MB
Formato Adobe PDF
1.14 MB Adobe PDF   Richiedi una copia

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1287798
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 28
  • ???jsp.display-item.citation.isi??? 25
social impact