Sinan Khadhouri1,2,3, Kevin M Gallagher3,4, Kenneth R MacKenzie3,5, Taimur T Shah3,6,7, Chuanyu Gao3,8, Sacha Moore3,9, Eleanor F Zimmermann3,10, Eric Edison3,11, Matthew Jefferies3,12, Arjun Nambiar3,5, Miles P Mannas13, Taeweon Lee13, Giancarlo Marra14,15, Beatrice Lillaz16, Juan Gómez Rivas17, Jonathan Olivier18, Mark A Assmus19, Taha Uçar20, Francesco Claps21, Matteo Boltri21, Tara Burnhope22, Nkwam Nkwam22, George Tanasescu23, Nicholas E Boxall24, Alison P Downey25, Asim Ahmed Lal26, Marta Antón-Juanilla27, Holly Clarke28, David Hw Lau2, Kathryn Gillams29, Matthew Crockett30, Matthew Nielsen26, Yemisi Takwoingi31, Naomi Chuchu32, John O'Rourke32, Graeme MacLennan33, John S McGrath34,35, Veeru Kasivisvanathan36,37,3. 1. University of Aberdeen, Health Services Research Unit, Aberdeen, UK. 2. Aberdeen Royal Infirmary, Aberdeen, UK. 3. British Urology Researchers in Surgical Training (BURST) Collaborative. 4. Department of Clinical Surgery, Western General Hospital, University of Edinburgh, Edinburgh, UK. 5. Freeman Hospital, Newcastle Upon Tyne, UK. 6. Charing Cross Hospital, Imperial College Healthcare NHS Trust, Dept. of Surgery and Cancer, London, UK. 7. Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK. 8. Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. 9. Wrexham Maelor Hospital, Wrexham, UK. 10. Torbay and South Devon NHS Foundation Trust, Torbay, UK. 11. Department of Urology, Whipps Cross Hospital, Barts Health NHS Trust, London, UK. 12. Morriston Hospital, Swansea, UK. 13. Department of Urologic Sciences, University of British Columbia, Vancouver, Canada. 14. Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy. 15. University of Turin, Turin, Italy. 16. SanGiovanni Battista Hospital, Turin, Italy. 17. Department of Urology, La Paz University Hospital, Madrid, Spain. 18. Urology department, Claude Huriez Hospital, CHU Lille, F-59000, Lille, France. 19. Division of Urology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. 20. Department of Urology, Istanbul Medeniyet University, Turkey. 21. Urological Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy. 22. University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK. 23. Department of Urology, Queen Alexandra Hospital, Portsmouth, UK. 24. alford Royal NHS Foundation Trust, Salford, UK. 25. Doncaster Royal Infirmary, UK. 26. University of North Carolina Hospitals, Chapel Hill, North Carolina, USA. 27. Department of Urology, Hospital Universitario Cruces, Barakaldo, Spain. 28. Bradford Teaching Hospitals, NHS Foundation Trust, UK. 29. Great Western Hospitals NHS Foundation Trust, Swindon, UK. 30. Frimley Renal Cancer Centre, Frimley Hospitals NHS Foundation Trust, UK. 31. Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, and NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK. 32. Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK. 33. Health Services Research Unit, University of Aberdeen, Aberdeen, UK. 34. University of Exeter Medical School, Exeter, UK. 35. Royal Devon and Exeter NHS Foundation Trust, Exeter, UK. 36. University College London, Division of Surgery and Interventional Science, UK. 37. University College London Hospitals NHS Foundation Trust, Dept. of Urology, London, UK.
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 and over, 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% CI 22.3-34.1), bladder cancer (n=1951) 24.7% (19.1-30.2), UTUC (n=128) 1.14% (0.77-1.52), renal cancer (n=107) 1.05% (0.80-1.29) and prostate cancer (n=124) 1.75% (1.32-2.18). 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 (2.90-4.15) p<0.0001, male sex 1.30 (1.14-1.50) p<0.001 and smoking 2.70 (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. This article is protected by copyright. All rights reserved.
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 and over, 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% CI 22.3-34.1), bladder cancer (n=1951) 24.7% (19.1-30.2), UTUC (n=128) 1.14% (0.77-1.52), renal cancer (n=107) 1.05% (0.80-1.29) and prostate cancer (n=124) 1.75% (1.32-2.18). 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 (2.90-4.15) p<0.0001, male sex 1.30 (1.14-1.50) p<0.001 and smoking 2.70 (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. This article is protected by copyright. All rights reserved.
Authors: Fabio Traunero; Francesco Claps; Tommaso Silvestri; Maria Carmen Mir; Luca Ongaro; Michele Rizzo; Andrea Piasentin; Giovanni Liguori; Francesca Vedovo; Antonio Celia; Carlo Trombetta; Nicola Pavan Journal: J Clin Med Date: 2022-06-30 Impact factor: 4.964
Authors: Jeremy Yuen-Chun Teoh; Ashish M Kamat; Peter C Black; Petros Grivas; Shahrokh F Shariat; Marek Babjuk Journal: Nat Rev Urol Date: 2022-03-31 Impact factor: 16.430
Authors: Andrea Piasentin; Francesco Claps; Tommaso Silvestri; Giacomo Rebez; Fabio Traunero; Maria Carmen Mir; Michele Rizzo; Antonio Celia; Calogero Cicero; Martina Urbani; Luca Balestreri; Lisa Pola; Fulvio Laganà; Stefano Cernic; Maria Assunta Cova; Michele Bertolotto; Carlo Trombetta; Giovanni Liguori; Nicola Pavan Journal: Medicina (Kaunas) Date: 2022-08-03 Impact factor: 2.948