The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study
Abstract Objectives To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy. Patients Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and...
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2025-01-01
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| Series: | BJUI Compass |
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| Online Access: | https://doi.org/10.1002/bco2.475 |
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| author | Sinan Khadhouri Kevin Gallagher Kenneth R. MacKenzie Taimur T. Shah Chuanyu Gao Eleanor Zimmermann Miles Mannas Taeweon Lee Giancarlo Marra Juan Gomez Rivas Gautier Marcq Mark A. Assmus Taha Ucar Francesco Claps Matteo Boltri Giuseppe Pizzuto Tara Burnhope Nkwam Nkwam George Tanasescu Nicholas E. Boxall Alison P. Downey Troy A. Sukhu Marta Antón‐Juanilla Sonpreet Rai Madeline Moore Kathryn Bandeira de Mello Sian Parsons John S. McGrath Veeru Kasivisvanathan IDENTIFY Study Group: Pubmed indexed collaborator authors |
| author_facet | Sinan Khadhouri Kevin Gallagher Kenneth R. MacKenzie Taimur T. Shah Chuanyu Gao Eleanor Zimmermann Miles Mannas Taeweon Lee Giancarlo Marra Juan Gomez Rivas Gautier Marcq Mark A. Assmus Taha Ucar Francesco Claps Matteo Boltri Giuseppe Pizzuto Tara Burnhope Nkwam Nkwam George Tanasescu Nicholas E. Boxall Alison P. Downey Troy A. Sukhu Marta Antón‐Juanilla Sonpreet Rai Madeline Moore Kathryn Bandeira de Mello Sian Parsons John S. McGrath Veeru Kasivisvanathan IDENTIFY Study Group: Pubmed indexed collaborator authors |
| author_sort | Sinan Khadhouri |
| collection | DOAJ |
| description | Abstract Objectives To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy. Patients Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy. Methods We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer‐associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious‐looking red patch (as reported by the cystoscopist). Sub‐analysis of these by clinical role and experience was performed. Results A total of 1110 patients with isolated de novo red patches were included. 41.5% (n = 461) were biopsied, with a malignancy rate of 12.8% (59/461), which was significantly higher in suspicious versus non‐suspicious red patches (19.1% vs. 2.81%, p < 0.01). There was a significant association between bladder cancer and age (OR 1.04, 95% CI 1.01–1.07, p = 0.01), smoking history (OR 2.62, 95% CI 1.09–6.27, p = 0.03) and suspicious‐looking patch (OR 6.50, 95% CI 2.47–17.1, p < 0.01). The majority of malignancies were in over 60‐year‐olds. Malignancy rates in suspicious versus non‐suspicious red patches did not differ significantly between clinical roles or experiences. Limitations included subjectivity in classifying a suspicious patch and selection bias as not all patches were biopsied. Conclusions Many patients still undergo unnecessary biopsies under general anaesthetic for isolated de novo red patches. Clinicians should consider the patient's age, smoking status and how suspicious‐looking the patch is, before deciding on surveillance versus biopsy to improve cancer diagnostic yield. |
| format | Article |
| id | doaj-art-dc765eb5293b47309c0d64b1e53a3e05 |
| institution | Kabale University |
| issn | 2688-4526 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | BJUI Compass |
| spelling | doaj-art-dc765eb5293b47309c0d64b1e53a3e052025-01-31T00:14:33ZengWileyBJUI Compass2688-45262025-01-0161n/an/a10.1002/bco2.475The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY studySinan Khadhouri0Kevin Gallagher1Kenneth R. MacKenzie2Taimur T. Shah3Chuanyu Gao4Eleanor Zimmermann5Miles Mannas6Taeweon Lee7Giancarlo Marra8Juan Gomez Rivas9Gautier Marcq10Mark A. Assmus11Taha Ucar12Francesco Claps13Matteo Boltri14Giuseppe Pizzuto15Tara Burnhope16Nkwam Nkwam17George Tanasescu18Nicholas E. Boxall19Alison P. Downey20Troy A. Sukhu21Marta Antón‐Juanilla22Sonpreet Rai23Madeline Moore24Kathryn Bandeira de Mello25Sian Parsons26John S. McGrath27Veeru Kasivisvanathan28IDENTIFY Study Group: Pubmed indexed collaborator authorsUniversity of St Andrews St Andrews United KingdomWestern General Hospital Edinburgh United KingdomSouth Tyneside and Sunderland NHS Foundation Trust Sunderland United KingdomImperial College London London United KingdomAddenbrookes Hospital Cambridge United KingdomUniversity Hospitals Plymouth Plymouth United KingdomDepartment of Urologic Sciences University of British Columbia Vancouver CanadaDepartment of Urologic Sciences University of British Columbia Vancouver CanadaDepartment of Surgical Sciences, Division of Urology, Città della Salute e della Scienza University of Turin Turin ItalyDepartment of Urology La Paz University Hospital Madrid SpainUrology Department Claude Huriez Hospital, CHU Lille Lille FranceSection of Urology, Department of Surgery University of Calgary Calgary Alberta CanadaPrivate Medicabil Hospital Department of Urology Bursa TurkeyUrological Clinic, Department of Medicine, Surgery and Health Sciences University of Trieste Trieste ItalyDepartment of Surgery, Division of Urology San Giovanni di Dio Hospital Gorizia ItalyUrological Clinic, Department of Medicine, Surgery and Health Sciences University of Trieste Trieste ItalyUniversity Hospitals Birmingham NHS Foundation Trust Birmingham United KingdomUniversity Hospitals of Derby and Burton NHS Foundation Trust Derby United KingdomDepartment of Urology Queen Alexandra Hospital Portsmouth United KingdomSalford Royal NHS Foundation Trust Salford United KingdomDoncaster Royal Infirmary Doncaster United KingdomUniversity of North Carolina Hospitals Chapel Hill NC USADepartment of Urology Hospital Universitario Cruces Barakaldo SpainMilton Keynes University Hospital NHS Foundation Trust Milton Keynes United KingdomUniversity Hospitals Birmingham NHS Foundation Trust Birmingham United KingdomRoyal Devon and Exeter NHS Foundation Trust Exeter United KingdomSouthmead Hospital Bristol United KingdomRoyal Devon and Exeter NHS Foundation Trust Exeter United KingdomUniversity College London London United KingdomAbstract Objectives To assess the contemporary malignancy rate in isolated de novo red patches in the bladder and associated risk factors for better selection of red patch biopsy. Patients Patients from the IDENTIFY dataset; Patients referred to secondary care with suspected urinary tract cancer and found to have isolated de novo red patches on cystoscopy. Methods We reported the unadjusted cancer prevalence in isolated de novo red patches that were biopsied; multivariable logistic regression was used to explore cancer‐associated risk factors including age, sex, smoking, type of haematuria, LUTS, UTIs and a suspicious‐looking red patch (as reported by the cystoscopist). Sub‐analysis of these by clinical role and experience was performed. Results A total of 1110 patients with isolated de novo red patches were included. 41.5% (n = 461) were biopsied, with a malignancy rate of 12.8% (59/461), which was significantly higher in suspicious versus non‐suspicious red patches (19.1% vs. 2.81%, p < 0.01). There was a significant association between bladder cancer and age (OR 1.04, 95% CI 1.01–1.07, p = 0.01), smoking history (OR 2.62, 95% CI 1.09–6.27, p = 0.03) and suspicious‐looking patch (OR 6.50, 95% CI 2.47–17.1, p < 0.01). The majority of malignancies were in over 60‐year‐olds. Malignancy rates in suspicious versus non‐suspicious red patches did not differ significantly between clinical roles or experiences. Limitations included subjectivity in classifying a suspicious patch and selection bias as not all patches were biopsied. Conclusions Many patients still undergo unnecessary biopsies under general anaesthetic for isolated de novo red patches. Clinicians should consider the patient's age, smoking status and how suspicious‐looking the patch is, before deciding on surveillance versus biopsy to improve cancer diagnostic yield.https://doi.org/10.1002/bco2.475biopsybladder cancercystoscopyhaematuriared patchrisk factors |
| spellingShingle | Sinan Khadhouri Kevin Gallagher Kenneth R. MacKenzie Taimur T. Shah Chuanyu Gao Eleanor Zimmermann Miles Mannas Taeweon Lee Giancarlo Marra Juan Gomez Rivas Gautier Marcq Mark A. Assmus Taha Ucar Francesco Claps Matteo Boltri Giuseppe Pizzuto Tara Burnhope Nkwam Nkwam George Tanasescu Nicholas E. Boxall Alison P. Downey Troy A. Sukhu Marta Antón‐Juanilla Sonpreet Rai Madeline Moore Kathryn Bandeira de Mello Sian Parsons John S. McGrath Veeru Kasivisvanathan IDENTIFY Study Group: Pubmed indexed collaborator authors The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study BJUI Compass biopsy bladder cancer cystoscopy haematuria red patch risk factors |
| title | The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study |
| title_full | The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study |
| title_fullStr | The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study |
| title_full_unstemmed | The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study |
| title_short | The significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer: Results from the IDENTIFY study |
| title_sort | significance of isolated de novo red patches in the bladder in patients referred with suspected urinary tract cancer results from the identify study |
| topic | biopsy bladder cancer cystoscopy haematuria red patch risk factors |
| url | https://doi.org/10.1002/bco2.475 |
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