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.
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