The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study.

Autor: Khadhouri S; Health Services Research Unit, University of Aberdeen, Aberdeen, UK.; Aberdeen Royal Infirmary, Aberdeen, UK.; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK., Gallagher KM; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Department of Clinical Surgery, Western General Hospital, University of Edinburgh, Edinburgh, UK., MacKenzie KR; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Freeman Hospital, Newcastle Upon Tyne, UK., Shah TT; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Dept. of Surgery and Cancer, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.; Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK., Gao C; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Moore S; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Wrexham Maelor Hospital, Wrexham, UK., Zimmermann EF; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Torbay and South Devon NHS Foundation Trust, Torbay, UK., Edison E; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Department of Urology, Whipps Cross Hospital, Barts Health NHS Trust, London, UK., Jefferies M; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Morriston Hospital, Swansea, UK., Nambiar A; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Freeman Hospital, Newcastle Upon Tyne, UK., Mannas MP; Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada., Lee T; Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada., Marra G; Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy.; University of Turin, Turin, Italy., Lillaz B; SanGiovanni Battista Hospital, Turin, Italy., Gómez Rivas J; Department of Urology, La Paz University Hospital, Madrid, Spain., Olivier J; Urology Department, Claude Huriez Hospital, CHU Lille, Lille, France., Assmus MA; Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada., Uçar T; Department of Urology, Istanbul Medeniyet University, Istanbul, Turkey., Claps F; Urological Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Boltri M; Urological Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Burnhope T; University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK., Nkwam N; University Hospitals of Derby and Burton NHS Foundation Trust, Derby, UK., Tanasescu G; Department of Urology, Queen Alexandra Hospital, Portsmouth, UK., Boxall NE; Salford Royal NHS Foundation Trust, Salford, UK., Downey AP; Doncaster Royal Infirmary, Doncaster, UK., Lal AA; University of North Carolina Hospitals, Chapel Hill, NC, USA., Antón-Juanilla M; Department of Urology, Hospital Universitario Cruces, Barakaldo, Spain., Clarke H; Bradford Teaching Hospitals, NHS Foundation Trust, Bradford, UK., Lau DHW; Aberdeen Royal Infirmary, Aberdeen, UK., Gillams K; Great Western Hospitals NHS Foundation Trust, Swindon, UK., Crockett M; Frimley Renal Cancer Centre, Frimley Hospitals NHS Foundation Trust, Camberley, UK., Nielsen M; University of North Carolina Hospitals, Chapel Hill, NC, USA., Takwoingi Y; Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK., Chuchu N; Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK., O'Rourke J; Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK., MacLennan G; Health Services Research Unit, University of Aberdeen, Aberdeen, UK., McGrath JS; University of Exeter Medical School, Exeter, UK.; Royal Devon and Exeter NHS Foundation Trust, Exeter, UK., Kasivisvanathan V; British Urology Researchers in Surgical Training (BURST) Collaborative, London, UK.; Division of Surgery and Interventional Science, University College London, London, UK.; Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
Jazyk: angličtina
Zdroj: BJU international [BJU Int] 2021 Oct; Vol. 128 (4), pp. 440-450. Date of Electronic Publication: 2021 Sep 08.
DOI: 10.1111/bju.15483
Abstrakt: 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.
(© 2021 The Authors BJU International published by John Wiley & Sons Ltd on behalf of BJU International.)
Databáze: MEDLINE
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