What is the relative risk of urologic malignancy in microscopic hematuria patients after negative evaluation? A long-term population-based retrospective analysis of 8465 patients

Objective To evaluate whether microscopic hematuria (MH) patients with a negative initial evaluation have an elevated risk for urinary carcinoma. Methods This is a population-based retrospective study with a matched control identified 8465 adults with an MH ICD code, an initial negative urinary mali...

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Bibliographic Details
Published in:Abdominal imaging 2023-03, Vol.48 (3), p.1011-1019
Main Authors: Lisanti, Christopher J., Graeber, Adam, Syed, Helal, Moeck, Adam, Rittel, Alexander G., Aden, James K., Schwope, Ryan, Jellison, Forrest
Format: Article
Language:English
Subjects:
Adult
Bladder
Cancer
Evaluation
Female
Females
Gastroenterology
Hematuria
Hepatology
Humans
Imaging
Kidneys
Male
Males
Malignancy
Medicine
Medicine & Public Health
Population studies
Radiology
Retroperitoneum
Retrospective Studies
Risk
Statistical analysis
Tomography, X-Ray Computed
Ureters
Urography
Urologic Neoplasms
Urological cancer
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Summary:Objective To evaluate whether microscopic hematuria (MH) patients with a negative initial evaluation have an elevated risk for urinary carcinoma. Methods This is a population-based retrospective study with a matched control identified 8465 adults with an MH ICD code, an initial negative urinary malignancy work-up of cystoscopy and CT urography, and at least 35 months of clinical care. 8465 hematuria naïve controls were age, gender, and smoking status matched. Subsequent coding of non-prostatic urinary cancer, or any following hematuria codes: additional microscopic unspecified or unspecified hematuria, and gross hematuria was obtained. Χ 2 tests were performed. Results There was no statistically significant difference in urinary malignancy rates ( p  > 0.05). Any urinary cancer: cases 0.74% (63/8465; 95% CI 0.58–0.95%)/controls 0.83% (71/8465; 95% CI 0.66–1.04%%) ( p  = 0.54); bladder: 0.45%/0.47% ( p  = 0.82); renal: 0.31%/0.38% ( p  = 0.43); ureteral: 0.01%/0.02% ( p  = 0.56). Subsequent gross hematuria in both males and females increased the odds of cancer: males 2.35 ( p  = 0.001; CI 1.42–3.91); females 4.25 ( p   0.05). Conclusion MH patients with initial negative evaluation have a subsequent urologic malignancy rate of less than 1% and likely do not need further urinary evaluation unless they develop gross hematuria. Graphical abstract
ISSN:2366-0058
2366-004X
2366-0058
DOI:10.1007/s00261-022-03793-x