
Venugopal P
Recent Posts

Suspensory ligament ...
09 Jun 2023 09:03:07 AM
Could the bulbar ure...
07 Jun 2023 12:26:00 PM
Spotter
19 Mar 2023 09:18:09 PM
A case: Diagnosis & ...
10 Mar 2023 08:34:24 AM
Posterior Urethra Ma...
15 Jan 2023 10:47:27 AMThe IDENTIFY Study: Investigation and Detection of Urological Neoplasia
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
Dr. Roy Chally
31 May 2021 11:18:57 PMThe 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.