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 years, 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% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The 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 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 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.
| Original language | English |
|---|---|
| Pages (from-to) | 440-450 |
| Number of pages | 11 |
| Journal | BJU International |
| Volume | 128 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Oct 2021 |
Keywords
- bladder cancer
- cancer prevalence
- haematuria
- hematuria
- prostate cancer
- renal cancer
- upper tract urothelial cancer
- urinary tract cancer
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In: BJU International, Vol. 128, No. 4, 10.2021, p. 440-450.
Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - The IDENTIFY study
T2 - the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer – a multicentre observational study
AU - Khadhouri, Sinan
AU - Gallagher, Kevin M.
AU - MacKenzie, Kenneth R.
AU - Shah, Taimur T.
AU - Gao, Chuanyu
AU - Moore, Sacha
AU - Zimmermann, Eleanor F.
AU - Edison, Eric
AU - Jefferies, Matthew
AU - Nambiar, Arjun
AU - Mannas, Miles P.
AU - Lee, Taeweon
AU - Marra, Giancarlo
AU - Lillaz, Beatrice
AU - Gómez Rivas, Juan
AU - Olivier, Jonathan
AU - Assmus, Mark A.
AU - Uçar, Taha
AU - Claps, Francesco
AU - Boltri, Matteo
AU - Burnhope, Tara
AU - Nkwam, Nkwam
AU - Tanasescu, George
AU - Boxall, Nicholas E.
AU - Downey, Alison P.
AU - Lal, Asim A.
AU - Antón-Juanilla, Marta
AU - Clarke, Holly
AU - Lau, David H.W.
AU - Gillams, Kathryn
AU - Crockett, Matthew
AU - Nielsen, Matthew
AU - Takwoingi, Yemisi
AU - Chuchu, Naomi
AU - O’Rourke, John
AU - MacLennan, Graeme
AU - McGrath, John S.
AU - Kasivisvanathan, Veeru
AU - Chaudry, Aasem
AU - Sharma, Abhishek
AU - Bennett, Adam
AU - Ahmad, Adnan
AU - Abroaf, Ahmed
AU - Suliman, Ahmed M.
AU - Lloyd, Aimee
AU - McKay, Alastair
AU - Wong, Albert
AU - Silva, Alberto
AU - Schneider, Alexandre
AU - MacKay, Alison
AU - Knight, Allen
AU - Grigorakis, Alkiviadis
AU - Bdesha, Amar
AU - Nagle, Amy
AU - Cebola, Ana
AU - Dhanasekaran, Ananda Kumar
AU - Kondža, Andraž
AU - Barcelos, André
AU - Galosi, Andrea B.
AU - Ebur, Andrea
AU - Minervini, Andrea
AU - Russell, Andrew
AU - Webb, Andrew
AU - García de Jalón, Ángel
AU - Desai, Ankit
AU - Czech, Anna K.
AU - Mainwaring, Anna
AU - Adimonye, Anthony
AU - Das, Arighno
AU - Figueiredo, Arnaldo
AU - Villers, Arnauld
AU - Leminski, Artur
AU - Chippagiri, Arvinda
AU - Yıldırım, Asıf
AU - Voulgaris, Athanasios M.
AU - Uzan, Audrey
AU - Oo, Aye Moh Moh
AU - Younis, Ayman
AU - Zelhof, Bachar
AU - Mukhtar, Bashir
AU - Ayres, Ben
AU - Challacombe, Ben
AU - Sherwood, Benedict
AU - Ristau, Benjamin
AU - Lai, Billy
AU - Nellensteijn, Brechtje
AU - Schreiter, Brielle
AU - Trombetta, Carlo
AU - Dowling, Catherine
AU - Hobbs, Catherine
AU - Benitez, Cayo Augusto Estigarribia
AU - Lebacle, Cédric
AU - Ho, Cherrie Wing Yin
AU - Ng, Chi Fai
AU - Mount, Chloe
AU - Lam, Chon Meng
AU - Blick, Chris
AU - Brown, Christian
AU - Gallegos, Christopher
AU - Higgs, Claire
AU - Browne, Clíodhna
AU - McCann, Conor
AU - Alonso, Cristina Plaza
AU - Beder, Daniel
AU - Cohen, Daniel
AU - Gordon, Daniel
AU - Wilby, Daniel
AU - Gordon, Danny
AU - Hrouda, David
AU - Karsza, Dávid
AU - Mak, David
AU - Martin-Way, David
AU - Suthaharan, Denula
AU - Patel, Dhruv
AU - Carrion, Diego M.
AU - Nyanhongo, Donald
AU - Bass, Edward
AU - Mains, Edward
AU - Chau, Edwin
AU - Castillo, Elba Canelon
AU - Day, Elizabeth
AU - Desouky, Elsayed
AU - Gaines, Emily
AU - Papworth, Emma
AU - Yuruk, Emrah
AU - Kilic, Enes
AU - Dinneen, Eoin
AU - Palagonia, Erika
AU - Xylinas, Evanguelos
AU - Khawaja, Faizan
AU - Cimarra, Fernando
AU - Bardet, Florian
AU - Kum, Francesca
AU - Peters, Francesca
AU - Kovács, Gábor
AU - Hellawell, Giles
AU - Tasso, Giovanni
AU - Lam, Gitte
AU - La Montagna, Giuseppe
AU - Pizzuto, Giuseppe
AU - Lenart, Gordan
AU - Özgür, Günal
AU - Bi, Hai
AU - Lyons, Hannah
AU - Warren, Hannah
AU - Ahmed, Hashim
AU - Simpson, Helen
AU - Burden, Helena
AU - Gresty, Helena
AU - Pita, Hernado Rios
AU - Serag, Hosam
AU - Kynaston, Howard
AU - Crawford-Smith, Hugh
AU - Mostafid, Hugh
AU - Otaola-Arca, Hugo
AU - Fen Koo, Hui
AU - Ibrahim, Ibrahim
AU - Ouzaid, Idir
AU - Puche-Sanz, Ignacio
AU - Tomašković, Igor
AU - Tinay, Ilker
AU - Sahibzada, Iqbal
AU - Thangasamy, Isaac
AU - Cadena, Iván Revelo
AU - Irani, Jacques
AU - Udzik, Jakub
AU - Brittain, James
AU - Catto, James
AU - Green, James
AU - Tweedle, James
AU - Hernando, Jamie Borrego
AU - Leask, Jamie
AU - Kalsi, Jas
AU - Frankel, Jason
AU - Toniolo, Jason
AU - Raman, Jay D.
AU - Courcier, Jean
AU - Kumaradeevan, Jeevan
AU - Clark, Jennifer
AU - Jones, Jennifer
AU - Teoh, Jeremy Yuen Chun
AU - Iacovou, John
AU - Kelly, John
AU - Selph, John P.
AU - Aning, Jonathan
AU - Deeks, Jon
AU - Maw, Jonny
AU - Herranz-Yagüe, José Antonio
AU - Nolazco, Jose Ignacio
AU - Cózar-Olmo, Jose Manuel
AU - Bagley, Joseph
AU - Jelski, Joseph
AU - Norris, Joseph
AU - Testa, Joseph
AU - Meeks, Joshua
AU - Hernandez, Juan
AU - Vásquez, Juan Luis
AU - Randhawa, Karen
AU - Dhera, Karishma
AU - Gronostaj, Katarzyna
AU - Houlton, Kathleen
AU - Lehman, Kathleen
AU - Adasonla, Kelvin
AU - Brown, Kevin
AU - Murtagh, Kevin
AU - Mistry, Kiki
AU - Davenport, Kim
AU - Kitamura, Kosuke
AU - Derbyshire, Laura
AU - Clarke, Laurence
AU - Morton, Lawrie
AU - Martinez, Levin
AU - Goldsmith, Louise
AU - Paramore, Louise
AU - Cormier, Luc
AU - Dell'Atti, Lucio
AU - Simmons, Lucy
AU - Martinez-Piñeiro, Luis
AU - Rico, Luis
AU - Chan, Luke
AU - Forster, Luke
AU - Ma, Lulin
AU - Moore, Madeline
AU - Gallego, Maria Camacho
AU - Freire, Maria José
AU - Emberton, Mark
AU - Feneley, Mark
AU - Rivero, Marta Viridiana Muñoz
AU - Pirša, Matea
AU - Tallè, Matteo
AU - Liew, Matthew
AU - Trail, Matthew
AU - Cooper, Meghan
AU - Kulkarni, Meghana
AU - Ager, Michael
AU - He, Ming
AU - Li, Mo
AU - Omran Breish, Mohamed
AU - Tarin, Mohamed
AU - Aldiwani, Mohammed
AU - Matanhelia, Mudit
AU - Pasha, Muhammad
AU - Sengupta, Shomik
AU - IDENTIFY Study group
N1 - Funding Information: We would like to thank all of the BURST research collaborators for taking part in this study and Jonathan Deeks for his support from the Test Evaluation Research Group. Veeru Kasivisvanathan is an Academic Clinical Lecturer funded by the UK National Institute for Health Research (NIHR). Yemisi Takwoingi is funded by a UK NIHR Postdoctoral Fellowship and supported by the NIHR Birmingham Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR or the Department of Health and Social Care. Although unrelated to the present study, the BURST research collaborative would like to acknowledge funding from the , BAUS, Ferring Pharmaceuticals Ltd, and Dominvs Group. BJU International Funding Information: Grants from Action Bladder Cancer UK, The Urology Foundation, The Rosetrees Trust were used for costs of statistical analysis and dissemination of results at international meetings and conferences. There were no endorsements from pharmaceutical companies or agencies to write this article. The corresponding author (Sinan Khadhouri) had full access to the data and held the final responsibility to submit the manuscript. Action Bladder Cancer UK, The Urology Foundation, The Rosetrees Trust. We would like to thank all of the BURST research collaborators for taking part in this study and Jonathan Deeks for his support from the Test Evaluation Research Group. Veeru Kasivisvanathan is an Academic Clinical Lecturer funded by the UK National Institute for Health Research (NIHR). Yemisi Takwoingi is funded by a UK NIHR Postdoctoral Fellowship and supported by the NIHR Birmingham Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, NIHR or the Department of Health and Social Care. Although unrelated to the present study, the BURST research collaborative would like to acknowledge funding from the BJU International, BAUS, Ferring Pharmaceuticals Ltd, and Dominvs Group. Publisher Copyright: © 2021 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.
PY - 2021/10
Y1 - 2021/10
N2 - 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 years, 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% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The 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 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 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.
AB - 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 years, 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% confidence interval [CI] 22.3–34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1–30.2), UTUC (n = 128) 1.14% (95% CI 0.77–1.52), renal cancer (n = 107) 1.05% (95% CI 0.80–1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32–2.18). The 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 (95% CI 2.90–4.15; P < 0.001), male sex 1.30 (95% CI 1.14–1.50; P < 0.001), and smoking 2.70 (95% CI 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.
KW - bladder cancer
KW - cancer prevalence
KW - haematuria
KW - hematuria
KW - prostate cancer
KW - renal cancer
KW - upper tract urothelial cancer
KW - urinary tract cancer
UR - http://www.scopus.com/inward/record.url?scp=85115243675&partnerID=8YFLogxK
U2 - 10.1111/bju.15483
DO - 10.1111/bju.15483
M3 - Article
C2 - 33991045
AN - SCOPUS:85115243675
SN - 1464-4096
VL - 128
SP - 440
EP - 450
JO - BJU International
JF - BJU International
IS - 4
ER -