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

摘要

Abstract 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 na?ve 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. Χ2 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