The IDENTIFY Study: Investigation and Detection of Urological Neoplasia

• 31 May 2021 11:20:33 AM
• |Onco Urology

Dear All,

This is the first study to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation.

This was an international multicentre prospective observational study. We included patients aged 16 and over, referred to secondary care with suspected urinary tract cancer.

Of the 11,059 patients assessed for eligibility, 10,896 were included from 110 hospitals across 26 countries. Most of the materials were provided from British Centres.

This study was undertaken with a view of a better understanding of cancer prevalence across an international population as it is required to inform clinical guidelines.

The study was reported by Sinan Khadhouri*, John S McGrath* et al (2021, BJUI Published Online)

https://bjui-journals.onlinelibrary.wiley.com/doi/pdf/10.1111/bju.15483 (Downloadable PDF available)

The authors concluded by stating that ‘this study provides a robust contemporary evaluation of cancer prevalence in patients referred to secondary care with suspected urinary tract cancer. Adjustment for patient risk markers and geographical variation resulted in a more accurate cancer prevalence’.

Patients are commonly referred with VH, and bladder cancer is the most prevalent cancer.

Taking this aspect as B Ca being more prevalent, a table is provided as to the incidence of B Ca with its prevalence in Visible haematuria and non-visible haematuria. This has been tabulated age group wise.

Bladder Cancer:

Age	Incidence (%)	Visible Haematuria (%)	Non-Visible Haematuria (%)
<35	0.77	4.73	0
35 - 39	0.87	7.32	1.19
40 - 44	1.18	8.33	0.75
45 - 49	2.31	9.97	0.88
50 - 54	4.25	12.8	2.27
55 - 59	6.25	13.6	4.76
60 - 64	11.6	22.5	4.86
65 - 69	15.2	25.7	4.87
70 - 74	18.8	28.0	7.60
>75	43.8	30.6	10.6

Though this study has an international flavour, it does not add much to the subject except for giving us information of a robust nature.

I do not know how many of us will think that this IDENTIFY study Contributed more than we already know from AUA and EAU Guidelines.

With Warm Regards,

Venu

 

Comments(1)

• 

  Dr. Roy Chally

  31 May 2021 11:18:57 PM

  The title of the paper and the stated objective of the study do not match. 

  
  

  The study was carried out in a secondary referral centre. How can one presume that those presenting with the symptoms stated were not diagnosed in the primary care centre and treated or referred elsewhere for treatment. This should affect the data conclusion. 

  
  

  In study 95% of the cases had micro or macro hematuria and were referred for suspected urological malignancy. In 5% the imaging studies in the primary centre were suspicious of CA in the urinary tract. This the group of patients investigated. Urinary cancers presenting with other symptoms or signs or lab studies in the primary care centre and diagnosed with CA urinary tract not included in this study. This explains the the error on the incidence of Carcinoma Prostate and possibly renal cancer. 

  
  

  The study period was for 1 year and 2m. With no follow up.  How can one conclude that all negative for CA in this period did not develop CA at a later date

  
  

  The incidence of CA with macro and micro hematuria in relation to age has little clinical value. No change in the protocol of investigations according to macro or micro hematuria or age of presentation is proposed. 

  
  

  Age sex and H/O smoking are known causes to affect the incidence of CA in the urinary tract. The data presented has little additional value

  
  

  This to me is a poorly designed study with no theoretical or practical use.