medwireNews: Compared with the general population, adults with a hospital-based diagnosis of hematuria have a long-term increased risk for cancer, particularly bladder and kidney cancers, according to a Danish study.
“These findings may indicate that hospital-based hematuria diagnosis is a marker of greater cancer risk and may inform follow-up recommendations for hematuria,” say the researchers who analyzed data from 134,173 adults with the condition.
Patients with hematuria had a 14.15-fold increased risk for any cancer relative to the general population in the first 3 months following the diagnosis, and although this dropped substantially to 1.88-fold between 3 months and 1 year of follow-up, it remained 1.11-fold higher at 5 years or longer.
The overall risk was mainly driven by elevated risks for bladder and kidney cancer, show the findings published in JAMA Network Open. The risk for kidney cancer was increased 6.14-fold in the 3 months to 1 year after the hematuria diagnosis, 1.92-fold at 1–5 years, and 1.46-fold at 5 years or more. The corresponding increases in risk for invasive bladder cancer were 9.28-, 2.11-, and 1.17-fold.
However, patients who underwent cystoscopy in the 3 months before or after their hematuria diagnosis had substantially lower risks than those who did not undergo this procedure. For instance, the risk for invasive bladder cancer in 1–5 years of follow-up was 0.42- and 0.36-fold higher for those who underwent cystoscopy in the 3 months before and 3 months after hematuria, respectively, than for the general population. By contrast, individuals who did not undergo cystoscopy had a 3.45-fold increased risk. Similar patterns were seen for noninvasive bladder and kidney cancer.
One explanation could be that “initial cystoscopy may lead to the detection of both invasive and noninvasive bladder cancer,” say Mette Nørgaard (Aarhus University Hospital) and co-researchers. “Prompt detection of noninvasive bladder tumors offers the potential for treatment and prevention of invasion, which may be associated with reduced long-term risk of invasive bladder cancer.”
Notwithstanding the increased risks identified, the researchers note that the cumulative incidence of cancer was low, at 4.81% at 3 months after the diagnosis of hematuria, 6.65% at 1 year, and 12.34% at 5 years for any cancer, and 1.98%, 2.26%, and 2.55%, respectively, for invasive bladder cancer.
By Catherine Booth
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