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 - IDENTIFY Study group
A2 - Østergren , Peter Busch
N1 - © 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 - Adult
KW - Aged
KW - Female
KW - Hematuria/etiology
KW - Humans
KW - Kidney Neoplasms/complications
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Referral and Consultation
KW - Ureteral Neoplasms/complications
KW - Urinary Bladder Neoplasms/complications
KW - urinary tract cancer
KW - haematuria
KW - renal cancer
KW - hematuria
KW - prostate cancer
KW - bladder cancer
KW - cancer prevalence
KW - upper tract urothelial cancer
UR - http://www.scopus.com/inward/record.url?scp=85115243675&partnerID=8YFLogxK
U2 - 10.1111/bju.15483
DO - 10.1111/bju.15483
M3 - Journal article
C2 - 33991045
SN - 1464-4096
VL - 128
SP - 440
EP - 450
JO - B J U International (Print)
JF - B J U International (Print)
IS - 4
ER -