section name header

Evidence summaries

Macroscopic Haematuria in the Diagnosis of Urological Cancers

On the basis of studies on referred patients the probability of urological cancer in patients with macroscopic haematuria may be so high that patients with macroscopic haematuria should undergo urological assessment. Level of evidence: "C"

A systematic review 1 including 20 studies (14 studies with a total of 1,185 subjects assessing sensitivity and 6 studies with a total of 1,976 subjects assessing positive predictive value) was abstracted in DARE. No study executed in a primary care setting was included. In referred patients the pooled sensitivity of macroscopic haematuria for bladder cancer was 0.83 (95% CI 0.80 to 0.85). For ureteral cancer, this was 0.66 (95% CI 0.53 to 0.77), for renal cancer 0.48 (95% CI 0.36 to 0.60). The pooled positive predictive value for urological cancer was 0.22 (95% CI 0.17 to 0.27) in referred patients in 6 studies. The positive predictive value was highest in patients aged 40 or more at 0.41.

Comment: Primary-care-based studies are needed.

References

  • Buntinx F, Wauters H. The diagnostic value of macroscopic haematuria in diagnosing urological cancers: a meta-analysis. Fam Pract 1997 Feb;14(1):63-8. [PubMed][DARE]

Primary/Secondary Keywords