Hematuria as a Marker of Occult Urinary Tract Cancer: Advice for High-Value Care From the American College of Physicians

Annals of Internal Medicine
Matthew NielsenHigh Value Care Task Force of the American College of Physicians

Abstract

The presence of blood in the urine, or hematuria, is a common finding in clinical practice and can sometimes be a sign of occult cancer. This article describes the clinical epidemiology of hematuria and the current state of practice and science in this context and provides suggestions for clinicians evaluating patients with hematuria. A narrative review of available clinical guidelines and other relevant studies on the evaluation of hematuria was conducted, with particular emphasis on considerations for urologic referral. Clinicians should include gross hematuria in their routine review of systems and specifically ask all patients with microscopic hematuria about any history of gross hematuria. Clinicians should not use screening urinalysis for cancer detection in asymptomatic adults. Clinicians should confirm heme-positive results of dipstick testing with microscopic urinalysis that demonstrates 3 or more erythrocytes per high-powered field before initiating further evaluation in all asymptomatic adults. Clinicians should refer for further urologic evaluation in all adults with gross hematuria, even if self-limited. Clinicians should consider urology referral for cystoscopy and imaging in adults with microscopically confirmed ...Continue Reading

Citations

Apr 14, 2016·Nature Reviews. Urology·Matthew G Kaag, Jay D Raman
Oct 15, 2019·Postgraduate Medicine·Varun KavuruJohn Robertson
May 6, 2020·European Heart Journal. Cardiovascular Pharmacotherapy·Peter Vibe RasmussenMorten Lock Hansen
Aug 22, 2020·PloS One·Herbert M HuttanusRyan S Senger
Mar 23, 2017·Applied Clinical Informatics·Daniel R MurphyHardeep Singh
Mar 28, 2017·Advances in Therapy·David DarlingJames Suttie
Feb 29, 2020·Research and Practice in Thrombosis and Haemostasis·Christian QvigstadUNKNOWN ADVANCE Working Group
Feb 6, 2017·Bladder Cancer·Richard S MatulewiczJoshua J Meeks
Apr 28, 2018·The Journal of Urology·Wei Shen TanUNKNOWN DETECT I Trial Collaborators
Jul 4, 2018·Antimicrobial Agents and Chemotherapy·Nathan R ShivelyBrooke K Decker
Nov 4, 2020·Journal of the American Heart Association·Sergio Raposeiras RoubínAndrés Íñiguez Romo
Feb 4, 2021·Respiratory Medicine Case Reports·Hiroshi SugimotoKazuhiro Kajimoto
Mar 16, 2021·Terapevticheskiĭ arkhiv·O M DrapkinaV N Larina
Sep 1, 2019·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·Y NeuzilletP Mongiat-Artus
Jun 3, 2021·Tomography : a Journal for Imaging Research·Nicole MorrisonAndreu F Costa
Jul 8, 2021·The New England Journal of Medicine·Julie R Ingelfinger
Jul 29, 2021·Urologic Oncology·Adam S FeldmanDaniel W Lin
May 26, 2017·Analytical Chemistry·Hesham K YosefKlaus Gerwert

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