Association of hematuria on microscopic urinalysis and risk of urinary tract cancer.
Jung H, Gleason JM, Loo RK et al.
Detecting urinary tract cancer is of paramount importance during hematuria evaluation. The American Urological Association (AUA) Best Practice Policy Recommendations suggest evaluation for urinary tract cancer in patients with microhematuria using upper-tract imaging, urine cytology, and cystoscopy (Urology 2001;57:599–603). Microhematuria is defined as ≥3 red blood cells per high-power field (RBC/HPF) in urinary sediment from at least two properly collected urinalysis specimens. The Canadian Urological Association (CUA) advocates a similar algorithm to evaluate patients with microhematuria, but only if they are aged >40 years.
In this large, retrospective, population-based cohort study, the authors evaluated patients who underwent microscopic urinalysis during 2004–2005 at a large, US managed-care organization. They identified over 772 000 patients who underwent urinalysis during the study period. After exclusions (previous hematuria, age <18 years, pregnancy, urinary tract infection, prior urinary tract cancer, and inpatient status), 309 402 patients were available for analysis, of whom 156 691 had hematuria.