Journal article
Microhematuria assessment an IBCN consensus-Based upon a critical review of current guidelines.
- Schmitz-Dräger BJ Urologie 24/Urologie Schön Klinik Nürnberg Fürth, Europa-Allee 1, Fürth, Germany; Department of Urology, Friedrich-Alexander-Universität, Erlangen, Germany. Electronic address: bernd_sd@yahoo.de.
- Kuckuck EC Urologie 24/Urologie Schön Klinik Nürnberg Fürth, Europa-Allee 1, Fürth, Germany.
- Zuiverloon TC Department of Urology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.
- Zwarthoff EC Department of Pathology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.
- Saltzman A Department of Urology, Louisiana State University Health Sciences Center, New Orleans, LA.
- Srivastava A Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, New York, NY.
- Hudson MA Department of Urology, Diagnostic Clinic of Longview, Longview, TX.
- Seiler R Department of Urology, Inselspital, University of Berne, Berne, Switzerland; Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
- Todenhöfer T Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada; Department of Urology, Eberhard-Karl University, Tübingen, Germany.
- Vlahou A Division of Biotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
- Grossman HB Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
- Schoenberg MP Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, New York, NY.
- Sanchez-Carbayo M Lucio Lascaray Research Center, University of the Basque Country, Vitoria-Gasteiz, Spain.
- Brünn LA Urologische Klinik, St. Franziskus Hospital, Bielefeld, Germany.
- van Rhijn BW Division of Surgical Oncology (Urology), Antoni van Leeuwenhoek Hospital, Netherlands Cancer Institute, Amsterdam, The Netherlands.
- Goebell PJ Department of Urology, Friedrich-Alexander-Universität, Erlangen, Germany.
- Kamat AM Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX.
- Roupret M Pitié Salpétrière Hospital, Assistance Publique- Hopitaux de Paris, University Paris 6, Paris, France.
- Shariat SF Department of Urology, Medical University of Vienna, Vienna, Austria.
- Kiemeney LA Department of Urology, Erasmus MC Cancer Institute, Erasmus MC, Rotterdam, The Netherlands.
- 2016-09-20
Published in:
- Urologic oncology. - 2016
Bladder cancer
Diagnosis
Disease management
Guidelines
Microhematuria
Urine cytology
Urine markers
Asymptomatic Diseases
Biomarkers
Consensus
Cystoscopy
Hematuria
Humans
Practice Guidelines as Topic
Prevalence
Risk Assessment
Symptom Assessment
Tomography, X-Ray Computed
Ultrasonography
Urinary Bladder Neoplasms
Urine
Urography
English
RATIONALE
Assessment of patients with asymptomatic microhematuria (aMh) has been a challenge to urologists for decades. The aMh is a condition with a high prevalence in the general population and also an established diagnostic indicator of bladder cancer. Acknowledging aMh needs to be assessed within a complex context, multiple guidelines have been developed to identify individuals at high risk of being diagnosed with bladder cancer.
MATERIAL & METHODS
This structured review and consensus of the International Bladder Cancer Network (IBCN) identified and examined 9 major guidelines. These recommendations are partly based on findings from a long-term study on the effects of home dipstick testing, but also on the assumption that early detection of malignancy might be beneficial.
RESULTS
Despite similar designs, these guidelines differ in a variety of parameters including definition of aMh, rating of risks, use of imaging modalities, and the role of urine cytology. In addition, recommendations for further follow-up after negative initial assessment are controversial. In this review, different aspects for aMh assessment are analyzed based upon the evidence currently available.
DISCUSSION
We question whether adherence to the complicated algorithms as recommended by most guidelines is practical for routine use. Based upon a consensus, the authors postulate a need for better tools. New concepts for risk assessment permitting improved risk stratification and prepone cystoscopy before refined imaging procedures (computed tomography scan and magnetic resonance imaging) are suggested.
Assessment of patients with asymptomatic microhematuria (aMh) has been a challenge to urologists for decades. The aMh is a condition with a high prevalence in the general population and also an established diagnostic indicator of bladder cancer. Acknowledging aMh needs to be assessed within a complex context, multiple guidelines have been developed to identify individuals at high risk of being diagnosed with bladder cancer.
MATERIAL & METHODS
This structured review and consensus of the International Bladder Cancer Network (IBCN) identified and examined 9 major guidelines. These recommendations are partly based on findings from a long-term study on the effects of home dipstick testing, but also on the assumption that early detection of malignancy might be beneficial.
RESULTS
Despite similar designs, these guidelines differ in a variety of parameters including definition of aMh, rating of risks, use of imaging modalities, and the role of urine cytology. In addition, recommendations for further follow-up after negative initial assessment are controversial. In this review, different aspects for aMh assessment are analyzed based upon the evidence currently available.
DISCUSSION
We question whether adherence to the complicated algorithms as recommended by most guidelines is practical for routine use. Based upon a consensus, the authors postulate a need for better tools. New concepts for risk assessment permitting improved risk stratification and prepone cystoscopy before refined imaging procedures (computed tomography scan and magnetic resonance imaging) are suggested.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.urolonc.2016.05.030
- PMID 27641313
- Persistent URL
- https://sonar.ch/global/documents/177799
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