The following is a summary of “Hematuria Cancer Risk Score: A Validation Study Demonstrating Reduction In The Number Needed To Investigate While Preserving Fidelity Of Cancer Detection,” published in the April 2023 issue of Urology by Tan et al.
Hematuria, a prevalent symptom of urinary tract cancer, necessitates selective screening protocols in affected patient groups. Differing guidelines on investigating hematuria presentations prompted the external validation of the Hematuria Cancer Risk Score (HCRS), an assessment tool aiming to discern patients requiring hematuria investigations. In this study, the HCRS, developed using a prospective cohort from 40 UK hospitals (DETECT 1; ClinicalTrials.gov: NCT02676180), underwent validation in a cohort of 500 consecutively referred patients undergoing accelerated access pathway investigations for hematuria.
Of these, 471 patients were analyzed, among whom 36 received a urinary tract cancer diagnosis (33 bladder cancers, 3 upper tract cancers). The HCRS exhibited good discriminatory ability (AUC: 0.727; 95% CI 0.650–0.804), with a selected cut-off score of 4.015, effectively identifying 97% of tumors while reducing the number of patients undergoing investigations by 15%, including all upper tract tumors except for one G1 Ta bladder cancer, indicating potential healthcare cost savings and offering a clinically adaptable tool for informed decision-making between patients and physicians.
This study validated the HCRS using a cohort of 500 consecutively referred patients undergoing accelerated access pathway investigations for hematuria. The HCRS, developed from a UK hospitals’ prospective cohort (DETECT 1; ClinicalTrials.gov: NCT02676180), showed promising discrimination, with a specified cut-off of 4.015 identifying 97% of tumors while sparing 15% of patients from invasive investigations, demonstrating potential healthcare cost savings and facilitating informed decision-making between patients and physicians.
Source: auajournals.org/doi/10.1097/JU.0000000000003315.01
