Hematuria Quantified: The Relationship between Quantitative Hematuria and Newly Diagnosed Bladder Tumors

Abstract

Introduction: Currently, there is no quantitative reference range for hematuria as a marker for urothelial cancers despite its worldwide use in this context. Materials and Methods: Analysis of the results of 100 consecutive newly diagnosed bladder tumors. Results: The sensitivity of quantitative hematuria in detecting bladder tumors at various thresholds is described, e.g. ranging from 68 to 90% and from 47 to 77% at 10 and 40/μl, respectively, depending on the number of urinalyses, period of observation and the stage of the disease. Infection was present in 28% of cases, and its effect on RBC concentration was marginal. Significant hematuria was present in 8% of cases longer than 1 year prior to diagnosis. Conclusion: There are major obstacles in utilising urinary concentration of RBC as a stand-alone screening test for bladder tumors. There is no safe lower limit. However, this study provides original data regarding the expected sensitivity at various thresholds and provides new evidence that the sensitivity is higher for invasive disease and better on multiple testing and clearly suggests that the latency of bladder tumors is longer than generally perceived.