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4. Developing a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study

Author

Chaudry, Aasem, Sharma, Abhishek, Bennett, Adam, Ahmad, Adnan, Abroaf, Ahmed, Suliman, Ahmed Musa, Lloyd, Aimee, McKay, Alastair, Wong, Albert, Silva, Alberto, Schneider, Alexandre, MacKay, Alison, Knight, Allen, Grigorakis, Alkiviadis, Bdesha, Amar, Nagle, Amy, Cebola, Ana, Dhanasekaran, Ananda Kumar, Kondža, Andraž, Barcelos, André, Galosi, Andrea Benedetto, Ebur, Andrea, Minervini, Andrea, Russell, Andrew, Webb, Andrew, de Jalón, Ángel García, Desai, Ankit, Czech, Anna Katarzyna, Mainwaring, Anna, Adimonye, Anthony, Das, Arighno, Figueiredo, Arnaldo, Villers, Arnauld, Leminski, Artur, Chippagiri, Arvinda, Lal, Asim Ahmed, Yıldırım, Asıf, Voulgaris, Athanasios Marios, Uzan, Audrey, Oo, Aye Moh Moh, Younis, Ayman, Zelhof, Bachar, Mukhtar, Bashir, Ayres, Ben, Challacombe, Ben, Sherwood, Benedict, Ristau, Benjamin, Lai, Billy, Nellensteijn, Brechtje, Schreiter, Brielle, Trombetta, Carlo, Dowling, Catherine, Hobbs, Catherine, Benitez, Cayo Augusto Estigarribia, Lebacle, Cédric, Ho, Cherrie Wing Yin, Ng, Chi-Fai, Mount, Chloe, Lam, Chon Meng, Blick, Chris, Brown, Christian, Gallegos, Christopher, Higgs, Claire, Browne, Clíodhna, McCann, Conor, Plaza Alonso, Cristina, Beder, Daniel, Cohen, Daniel, Gordon, Daniel, Wilby, Daniel, Gordon, Danny, Hrouda, David, Lau, David Hua Wu, Karsza, Dávid, Mak, David, Martin-Way, David, Suthaharan, Denula, Patel, Dhruv, Carrion, Diego M, Nyanhongo, Donald, Bass, Edward, Mains, Edward, Chau, Edwin, Canelon Castillo, Elba, Day, Elizabeth, Desouky, Elsayed, Gaines, Emily, Papworth, Emma, Yuruk, Emrah, Kilic, Enes, Dinneen, Eoin, Palagonia, Erika, Xylinas, Evanguelos, Khawaja, Faizan, Cimarra, Fernando, Bardet, Florian, Kum, Francesca, Peters, Francesca, Kovács, Gábor, Tanasescu, Geroge, Hellawell, Giles, Tasso, Giovanni, Lam, Gitte, La Montagna, Giuseppe, Pizzuto, Giuseppe, Lenart, Gordan, MacLennan, Graeme, Özgür, Günal, Bi, Hai, Lyons, Hannah, Warren, Hannah, Ahmed, Hashim, Simpson, Helen, Burden, Helena, Gresty, Helena, Rios Pita, Hernado, Clarke, Holly, Serag, Hosam, Kynaston, Howard, Crawford-Smith, Hugh, Mostafid, Hugh, Otaola-Arca, Hugo, Koo, Hui Fen, Ibrahim, Ibrahim, Ouzaid, Idir, Puche-Sanz, Ignacio, Tomašković, Igor, Tinay, Ilker, Sahibzada, Iqbal, Thangasamy, Isaac, Cadena, Iván Revelo, Irani, Jacques, Udzik, Jakub, Brittain, James, Catto, James, Green, James, Tweedle, James, Hernando, Jamie Borrego, Leask, Jamie, Kalsi, Jas, Frankel, Jason, Toniolo, Jason, Raman, Jay D., Courcier, Jean, Kumaradeevan, Jeevan, Clark, Jennifer, Jones, Jennifer, Teoh, Jeremy Yuen-Chun, Iacovou, John, Kelly, John, Selph, John P., Aning, Jonathan, Deeks, Jon, Cobley, Jonathan, Olivier, Jonathan, Maw, Jonny, Herranz-Yagüe, José Antonio, Nolazco, Jose Ignacio, Cózar-Olmo, Jose Manuel, Bagley, Joseph, Jelski, Joseph, Norris, Joseph, Testa, Joseph, Meeks, Joshua, Hernandez, Juan, Vásquez, Juan Luis, Randhawa, Karen, Dhera, Karishma, Gronostaj, Katarzyna, Houlton, Kathleen, Lehman, Kathleen, Gillams, Kathryn, Adasonla, Kelvin, Brown, Kevin, Murtagh, Kevin, Mistry, Kiki, Davenport, Kim, Kitamura, Kosuke, Derbyshire, Laura, Clarke, Laurence, Morton, Lawrie, Martinez, Levin, Goldsmith, Louise, Paramore, Louise, Cormier, Luc, Dell'Atti, Lucio, Simmons, Lucy, Martinez-Piñeiro, Luis, Rico, Luis, Chan, Luke, Forster, Luke, Ma, Lulin, Moore, Madeline, Gallego, Maria Camacho, Freire, Maria José, Emberton, Mark, Feneley, Mark, Antón-Juanilla, Marta, Rivero, Marta Viridiana Muñoz, Pirša, Matea, Tallè, Matteo, Crockett, Matthew, Liew, Matthew, Trail, Matthew, Peters, Max, Cooper, Meghan, Kulkarni, Meghana, Ager, Michael, He, Ming, Li, Mo, Omran Breish, Mohamed, Tarin, Mohamed, Aldiwani, Mohammed, Matanhelia, Mudit, Pasha, Muhammad, Akalın, Mustafa Kaan, Abdullah, Nasreen, Hale, Nathan, Gadiyar, Neha, Kocher, Neil, Bullock, Nicholas, Campain, Nicholas, Pavan, Nicola, Al-Ibraheem, Nihad, Bhatt, Nikita, Bedi, Nishant, Shrotri, Nitin, Lobo, Niyati, Balderas, Olga, Kouli, Omar, Capoun, Otakar, Oteo Manjavacas, Pablo, Gontero, Paolo, Mariappan, Paramananthan, Marchiñena, Patricio Garcia, Erotocritou, Paul, Sweeney, Paul, Planelles, Paula, Acher, Peter, Black, Peter C., Osei-Bonsu, Peter K, Østergren, Peter, Smith, Peter, Willemse, Peter-Paul Michiel, Chlosta, Piotr L., Ul Ain, Qurrat, Barratt, Rachel, Esler, Rachel, Khalid, Raihan, Hsu, Ray, Stamirowski, Remigiusz, Mangat, Reshma, Cruz, Ricardo, Ellis, Ricky, Adams, Robert, Hessell, Robert, Oomen, Robert J.A., McConkey, Robert, Ritchie, Robert, Jarimba, Roberto, Chahal, Rohit, Andres, Rosado Mario, Hawkins, Rosalyn, David, Rotimi, Manecksha, Rustom P., Agrawal, Sachin, Hamid, Syed Sami, Deem, Samuel, Goonewardene, Sanchia, Swami, Satchi Kuchibhotla, Hori, Satoshi, Khan, Shahid, Mohammud Inder, Shakeel, Sangaralingam, Shanthi, Marathe, Shekhar, Raveenthiran, Sheliyan, Horie, Shigeo, Sengupta, Shomik, Parson, Sian, Parker, Sidney, Hawlina, Simon, Williams, Simon, Mazzoli, Simone, Grzegorz Kata, Slawomir, Pinheiro Lopes, Sofia, Ramos, Sónia, Rai, Sonpreet, Rintoul-Hoad, Sophie, O'Meara, Sorcha, Morris, Steve, Turner, Stacey, Venturini, Stefano, Almpanis, Stephanos, Joniau, Steven, Jain, Sunjay, Mallett, Susan, Nikles, Sven, Shahzad, Yan, Sylvia, Lee, Taeweon, Uçar, Taha, Drake, Tamsin, Toma, Tarq, Cabañuz Plo, Teresa, Bonnin, Thierry, Muilwijk, Tim, Wollin, Tim, Chu, Timothy Shun Man, Appanna, Timson, Brophy, Tom, Ellul, Tom, Austin, Tomas, Smrkolj, Tomaž, Rowe, Tracey, Sukhu, Troy, Patel, Trushar, Garg, Tullika, Çaşkurlu, Turhan, Bele, Uros, Haroon, Usman, Crespo-Atín, Víctor, Parejo Cortes, Victor, Capapé Poves, Victoria, Gnanapragasam, Vincent, Gauhar, Vineet, During, Vinnie, Kumar, Vivek, Fiala, Vojtech, Mahmalji, Wasim, Lam, Wayne, Fung Chin, Yew, Filtekin, Yigit, Chyn Phan, Yih, Ibrahim, Youssed, Glaser, Zachary A, Abiddin, Zainal Adwin, Qin, Zijian, Zotter, Zsuzsanna, Zainuddin, Zulkifli, Khadhouri, Sinan, Gallagher, Kevin M., MacKenzie, Kenneth R., Shah, Taimur T., Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F., Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Anbarasan, Thineskrishna, Mannas, Miles P., Marra, Giancarlo, Gómez Rivas, Juan, Marcq, Gautier, Assmus, Mark A., Claps, Francesco, Boltri, Matteo, Burnhope, Tara, Nkwam, Nkwam, Boxall, Nicholas E., Downey, Alison P., Sukhu, Troy A., Chin, Yew-Fung, Green, James S.A., Goulao, Beatriz, Nielsen, Matthew, McGrath, John S., and Kasivisvanathan, Veeru

Published
2022
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10. The IDENTIFY Study: The Investigation and Detection of Urological Neoplasia in Patients Referred with Suspected Urinary Tract Cancer; A multicentre observational study

Author

Khadhouri, Sinan, Gallagher, Kevin M., MacKenzie, Kenneth R., Shah, Taimur T., Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F., Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Mannas, Miles P., Lee, Taeweon, Marra, Giancarlo, Lillaz, Beatrice, Gómez Rivas, Juan, Olivier, Jonathan, Assmus, Mark A., Uçar, Taha, Claps, Francesco, Boltri, Matteo, Burnhope, Tara, Nkwam, Nkwam, Tanasescu, George, Boxall, Nicholas E., Downey, Alison P., Lal, Asim A, Antón-Juanilla, Marta, Clarke, Holly, Lau, David H. W., Gillams, Kathryn, Crockett, Matthew, Nielsen, Matthew, Takwoingi, Yemisi, Chuchu, Naomi, O'Rourke, John, MacLennan, Graeme, McGrath, John S., Kasivisvanathan, Veeru, Chaudry, Aasem, Sharma, Abhishek, Bennett, Adam, Ahmad, Adnan, Abroaf, Ahmed, Suliman, Ahmed M, Lloyd, Aimee, McKay, Alastair, Wong, Albert, Silva, Alberto, Schneider, Alexandre, MacKay, Alison, Knight, Allen, Grigorakis, Alkiviadis, Bdesha, Amar, Nagle, Amy, Cebola, Ana, Dhanasekaran, Ananda Kumar, Kond?a, Andra?, Barcelos, André, Galosi, Andrea B, Ebur, Andrea, Minervini, Andrea, Russell, Andrew, Webb, Andrew, García de Jalón, Ángel, Desai, Ankit, Czech, Anna K, Mainwaring, Anna, Adimonye, Anthony, Das, Arighno, Figueiredo, Arnaldo, Villers, Arnauld, Leminski, Artur, Chippagiri, Arvinda, Y?ld?r?m, As?f, Voulgaris, Athanasios M, Uzan, Audrey, Oo, Aye Moh Moh, Younis, Ayman, Zelhof, Bachar, Mukhtar, Bashir, Ayres, Ben, Challacombe, Ben, Sherwood, Benedict, Ristau, Benjamin, Lai, Billy, Nellensteijn, Brechtje, Schreiter, Brielle, Trombetta, Carlo, Dowling, Catherine, Hobbs, Catherine, Benitez, Cayo Augusto Estigarribia, Lebacle, Cédric, Ho, Cherrie Wing Yin, Ng, ChiFai, Mount, Chloe, Lam, Chon Meng, Blick, Chris, Brown, Christian, Gallegos, Christopher, Higgs, Claire, Browne, Clíodhna, McCann, Conor, Alonso, Cristina Plaza, Beder, Daniel, Cohen, Daniel, Gordon, Daniel, Wilby, Daniel, Gordon, Danny, Lau, David Hua Wu, Hrouda, David, Karsza, Dávid, Mak, David, Martin-Way, David, Suthaharan, Denula, Patel, Dhruv, Carrion, Diego M, Nyanhongo, Donald, Bass, Edward, Mains, Edward, Chau, Edwin, Castillo, Elba Canelon, Day, Elizabeth, Desouky, Elsayed, Gaines, Emily, Papworth, Emma, Yuruk, Emrah, Kilic, Enes, Dinneen, Eoin, Palagonia, Erika, Xylinas, Evanguelos, Khawaja, Faizan, Cimarra, Fernando, Bardet, Florian, Kum, Francesca, Peters, Francesca, Kovács, Gábor, Tanasescu, Geroge, Hellawell, Giles, Tasso, Giovanni, Lam, Gitte, La Montagna, Giuseppe, Pizzuto, Giuseppe, Lenart, Gordan, Özgür, Günal, Bi, Hai, Lyons, Hannah, Warren, Hannah, Ahmed, Hashim, Simpson, Helen, Burden, Helena, Gresty, Helena, Pita, Hernado Rios, Serag, Hosam, Kynaston, Howard, Crawford-Smith, Hugh, Mostafid, Hugh, Otaola-Arca, Hugo, Fen Koo, Hui, Ibrahim, Ibrahim, Ouzaid, Idir, Puche-Sanz, Ignacio, Tomakovi, Igor, Tinay, Ilker, Sahibzada, Iqbal, Thangasamy, Isaac, Cadena, Iván Revelo, Irani, Jacques, Udzik, Jakub, Brittain, James, Catto, James, Green, James, Tweedle, James, Hernando, Jamie Borrego, Leask, Jamie, Kalsi, Jas, Frankel, Jason, Toniolo, Jason, Raman, Jay D, Courcier, Jean, Kumaradeevan, Jeevan, Clark, Jennifer, Jones, Jennifer, Teoh, Jeremy YuenChun, Iacovou, John, Kelly, John, Selph, John P, Aning, Jonathan, Deeks, Jon, Maw, Jonny, Herranz-Yagüe, José Antonio, Nolazco, Jose Ignacio, Cózar-Olmo, Jose Manuel, Bagley, Joseph, Jelski, Joseph, Norris, Joseph, Testa, Joseph, Meeks, Joshua, Hernandez, Juan, Vásquez, Juan Luis, Randhawa, Karen, Dhera, Karishma, Gronostaj, Katarzyna, Houlton, Kathleen, Lehman, Kathleen, Adasonla, Kelvin, Brown, Kevin, Murtagh, Kevin, Mistry, Kiki, Davenport, Kim, Kitamura, Kosuke, Derbyshire, Laura, Clarke, Laurence, Morton, Lawrie, Martinez, Levin, Goldsmith, Louise, Paramore, Louise, Cormier, Luc, Dell'Atti, Lucio, Simmons, Lucy, Martinez-Piñeiro, Luis, Rico, Luis, Chan, Luke, Forster, Luke, Ma, Lulin, Moore, Madeline, Gallego, Maria Camacho, Freire, Maria José, Emberton, Mark, Feneley, Mark, Rivero, Marta Viridiana Muñoz, Pira, Matea, Tallè, Matteo, Liew, Matthew, Trail, Matthew, Cooper, Meghan, Kulkarni, Meghana, Ager, Michael, He, Ming, Li, Mo, Omran Breish, Mohamed, Tarin, Mohamed, Aldiwani, Mohammed, Matanhelia, Mudit, Pasha, Muhammad, Akaln, Mustafa Kaan, Abdullah, Nasreen, Hale, Nathan, Gadiyar, Neha, Kocher, Neil, Bullock, Nicholas, Campain, Nicholas, Pavan, Nicola, Al?Ibraheem, Nihad, Bhatt, Nikita, Bedi, Nishant, Shrotri, Nitin, Lobo, Niyati, Balderas, Olga, Kouli, Omar, Capoun, Otakar, Manjavacas, Pablo Oteo, Gontero, Paolo, Mariappan, Paramananthan, Marchiñena, Patricio Garcia, Erotocritou, Paul, Sweeney, Paul, Planelles, Paula, Acher, Peter, Black, Peter C, Osei?Bonsu, Peter K, Østergren, Peter, Smith, Peter, Willemse, Peter-Paul Michiel, Chlosta, Piotr L, Ul Ain, Qurrat, Barratt, Rachel, Esler, Rachel, Khalid, Raihan, Hsu, Ray, Stamirowski, Remigiusz, Mangat, Reshma, Cruz, Ricardo, Ellis, Ricky, Adams, Robert, Hessell, Robert, Oomen, Robert J.A., McConkey, Robert, Ritchie, Robert, Jarimba, Roberto, Chahal, Rohit, Andres, Rosado Mario, Hawkins, Rosalyn, David, Rotimi, Manecksha, Rustom P, Agrawal, Sachin, Hamid, Syed Sami, Deem, Samuel, Goonewardene, Sanchia, Swami, Satchi Kuchibhotla, Hori, Satoshi, Khan, Shahid, Inder, Shakeel Mohammud, Sangaralingam, Shanthi, Marathe, Shekhar, Raveenthiran, Sheliyan, Horie, Shigeo, Sengupta, Shomik, Parson, Sian, Parker, Sidney, Hawlina, Simon, Williams, Simon, Mazzoli, Simone, Kata, Slawomir Grzegorz, Lopes, Sofia Pinheiro, Ramos, Sónia, Rai, Sonpreet, Rintoul-Hoad, Sophie, O'Meara, Sorcha, Morris, Steve, Turner, Stacey, Venturini, Stefano, Almpanis, Stephanos, Joniau, Steven, Jain, Sunjay, Mallett, Susan, Nikles, Sven, Yan, Shahzad Sylvia, Drake, Tamsin, Toma, Tarq, Plo, Teresa Cabañuz, Bonnin, Thierry, Muilwijk, Tim, Wollin, Tim, Chu, Timothy Shun Man, Appanna, Timson, Brophy, Tom, Ellul, Tom, Austin, Tomas, Smrkolj, Toma, Rowe, Tracey, Sukhu, Troy, Patel, Trushar, Garg, Tullika, Çakurlu, Turhan, Bele, Uros, Haroon, Usman, Crespo-Atín, Víctor, Cortes, Victor Parejo, Poves, Victoria Capapé, Gnanapragasam, Vincent, Gauhar, Vineet, During, Vinnie, Kumar, Vivek, Fiala, Vojtech, Mahmalji, Wasim, Lam, Wayne, Chin, Yew Fung, Filtekin, Yigit, Phan, Yih Chyn, Ibrahim, Youssed, Glaser, Zachary A, Adwin, Zainal, Qin, Zijian, Zotter, Zsuzsanna, Zainuddin, Zulkifli, Khadhouri, Sinan, Gallagher, Kevin M, Mackenzie, Kenneth R, Shah, Taimur T, Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F, Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Mannas, Miles P, Lee, Taeweon, Marra, Giancarlo, Lillaz, Beatrice, Gómez Rivas, Juan, Olivier, Jonathan, Assmus, Mark A, Uçar, Taha, Claps, Francesco, Boltri, Matteo, Burnhope, Tara, Nkwam, Nkwam, Tanasescu, George, Boxall, Nicholas E, Downey, Alison P, Lal, Asim Ahmed, Antón-Juanilla, Marta, Clarke, Holly, Hw Lau, David, Gillams, Kathryn, Crockett, Matthew, Nielsen, Matthew, Takwoingi, Yemisi, Chuchu, Naomi, O'Rourke, John, Maclennan, Graeme, Mcgrath, John S, Kasivisvanathan, Veeru, Khadhouri, Sinan [0000-0002-1836-8992], Moore, Sacha [0000-0002-0914-2051], Gómez Rivas, Juan [0000-0002-0556-3035], Olivier, Jonathan [0000-0002-5409-2911], Assmus, Mark A [0000-0003-3615-9251], Claps, Francesco [0000-0003-2812-5553], Nkwam, Nkwam [0000-0003-1086-6388], and Apollo - University of Cambridge Repository

Subjects
Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, Male, =+16+years%2C+referred+to+secondary+care+with+suspected+urinary+tract+cancer%2E+Patients+with+a+known+or+previous+urological+malignancy+were+excluded%2E+We+estimated+the+prevalence+of+bladder+cancer%2C+UTUC%2C+renal+cancer+and+prostate+cancer%22">Objective To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged >= 16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer, stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05, P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15, P < 0.001), male sex 1.30 (95% CI 1.14-1.50, P < 0.001), and smoking 2.70 (95% CI 2.30-3.18, P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer, renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), bladder cancer, cancer prevalence, haematuria, hematuria, prostate cancer, renal cancer, upper tract urothelial cancer, urinary tract cancer, Adult, Aged, Female, Hematuria, Humans, Kidney Neoplasms, Middle Aged, Prospective Studies, Referral and Consultation, Ureteral Neoplasms, Urinary Bladder Neoplasms, Disease, urologic and male genital diseases, Prostate cancer, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, =+16+years%22">adjusted for established patient risk markers and geographical variation. Patients and Methods This was an international multicentre prospective observational study. We included patients aged >= 16 years, Medicine, bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, education.field_of_study, and smoking 2.70 (95% CI 2.30-3.18, stratified by age, female genital diseases and pregnancy complications, renal cancer and prostate cancer, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer, age 1.04 (95% CI 1.03-1.05 [stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. Results Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were], UTUC (n = 128) 1.14% (95% CI 0.77-1.52), 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), visible haematuria 3.47 (95% CI 2.90-4.15, type of haematuria, P < 0.001), medicine.medical_specialty, Urology, Urinary system, Population, and countries. Results Of the 11 059 patients assessed for eligibility, Malignancy, smoking, UTUC, Internal medicine, sex, education, Bladder cancer, and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05, business.industry, Cancer, Odds ratio, medicine.disease, male sex 1.30 (95% CI 1.14-1.50, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, P < 0.001). Conclusions A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, hospitals, business
Abstract

Funder: Action Bladder Cancer UK, Funder: Rosetrees Trust; Id: http://dx.doi.org/10.13039/501100000833, Funder: Urology Care Foundation; Id: http://dx.doi.org/10.13039/100006280, OBJECTIVE: To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation. PATIENTS AND METHODS: This was an international multicentre prospective observational study. We included patients aged ≥16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries. RESULTS: Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3-34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1-30.2), UTUC (n = 128) 1.14% (95% CI 0.77-1.52), renal cancer (n = 107) 1.05% (95% CI 0.80-1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32-2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03-1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90-4.15; P < 0.001), male sex 1.30 (95% CI 1.14-1.50; P < 0.001), and smoking 2.70 (95% CI 2.30-3.18; P < 0.001). CONCLUSIONS: A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer.

Published
2021
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15. Defining a national reference level for intraoperative radiation exposure in urological procedures: FLASH, a retrospective multicentre UK study

Author

Simson, Nick, primary, Stonier, Thomas, additional, Suleyman, Narin, additional, Hendry, Jane, additional, Salib, Miriam, additional, Peacock, Julian, additional, Connor, Martin, additional, Jones, Oliver, additional, Schuster-Bruce, James, additional, Bottrell, Oliver, additional, Lovegrove, Catherine, additional, English, Louise, additional, Hamami, Heba, additional, Horn, Charles, additional, Bagley, Joseph, additional, Bareh, Abdurahman, additional, Jaikaransingh, Dominic, additional, Mohamed, Nusrat, additional, Ukwu, Uchenna, additional, Shanmugathas, Nimlan, additional, Batura, Deepak, additional, McDonald, Jean, additional, Charitopoulos, Konstantinos, additional, Graham, Alison, additional, Zakikhani, Paimaun, additional, Taneja, Sanjeev, additional, Sells, Henry, additional, Bolgeri, Marco, additional, Wiseman, Oliver, additional, Bycroft, John, additional, Qteishat, Ahmed, additional, and Aboumarzouk, Omar, additional

Published
2019
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16. PD01-11 DEFINING A NATIONAL REFERENCE LEVEL FOR INTRA-OPERATIVE RADIATION EXPOSURE IN UROLOGICAL PROCEDURES: FLASH; A RETROSPECTIVE MULTI-CENTRE STUDY

Author

Simson*, Nick, primary, Stonier, Thomas, additional, Suleyman, Narin, additional, Peacock, Julian, additional, Salib, Miriam, additional, Bottrell, Oliver, additional, Connor, Martin, additional, Hendry, Jane, additional, Jones, Oliver, additional, Schuster-Bruce, James, additional, Horn, Charles, additional, English, Louise, additional, Hamami, Heba, additional, Lovegrove, Catherine, additional, Bagley, Joseph, additional, Bareh, Abdurahman, additional, Jaikaransingh, Dominic, additional, Mohamed, Nusrat, additional, Ukwu, Uchenna, additional, Shanmugathas, Nimlan, additional, Bycroft, John, additional, Wiseman, Oliver, additional, Qteishat, Ahmed, additional, Bolgeri, Marco, additional, and Aboumarzouk, Omar, additional

Published
2019
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18. Defining a national reference level for intraoperative radiation exposure in urological procedures: FLASH, a retrospective multicentre UK study.

Author

Simson, Nick, Stonier, Thomas, Suleyman, Narin, Hendry, Jane, Salib, Miriam, Peacock, Julian, Connor, Martin, Jones, Oliver, Schuster‐Bruce, James, Bottrell, Oliver, Lovegrove, Catherine, English, Louise, Hamami, Heba, Horn, Charles, Bagley, Joseph, Bareh, Abdurahman, Jaikaransingh, Dominic, Mohamed, Nusrat, Ukwu, Uchenna, and Shanmugathas, Nimlan

Subjects
RADIATION exposure, PERCUTANEOUS nephrolithotomy, HOSPITAL utilization, UROLOGICAL surgery, FLUOROSCOPY, RADIATION
Abstract

Objectives: To define reference levels for intraoperative radiation during stent insertion, ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL); to identify variation in radiation exposure between individual hospitals across the UK, between low‐ and high‐volume PCNL centres, and between grade of lead surgeon. Patients/Subjects and Methods: In all, 3651 patients were identified retrospectively across 12 UK hospitals over a 1‐year period. Radiation exposure was defined in terms of total fluoroscopy time (FT) and dose area product (DAP). The 75th percentiles of median values for each hospital were used to define reference levels for each procedure. Results: Reference levels: ureteric stent insertion/replacement (DAP, 2.3 Gy/cm2; FT, 49 s); URS (DAP, 2.8 Gy/cm2; FT, 57 s); PCNL (DAP, 24.1 Gy/cm2; FT, 431 s). Significant variations in the median DAP and FT were identified between individual centres for all procedures (P < 0.001). For PCNL, there was a statistically significant difference between DAP for low‐ (<50 cases/annum) and high‐volume centres (>50 cases/annum), at a median DAP of 15.0 Gy/cm2 vs 4.2 Gy/cm2 (P < 0.001). For stent procedures, the median DAP and FT differed significantly between grade of lead surgeon: Consultant (DAP, 2.17 Gy/cm2; FT, 41 s) vs Registrar (DAP, 1.38 Gy/cm2; FT, 26 s; P < 0.001). Conclusion: This multicentre study is the largest of its kind. It provides the first national reference level to guide fluoroscopy use in urological procedures, thereby adding a quantitative and objective value to complement the principles of keeping radiation exposure 'as low as reasonably achievable'. This snapshot of real‐time data shows significant variation around the country, as well as significant differences between low‐ and high‐volume centres for PCNL, and grade of lead surgeon for stent procedures. [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
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20. School Desegregation, Law and Order, and Litigating Social Justice in Alabama, 1954-1973

Author

Bagley, Joseph

Abstract

This study examines the legal struggle over school desegregation in Alabama in the two decades following the Supreme Court?s Brown v. Board decision of 1954. It seeks to better understand the activists who mounted a litigious assault on segregated education, the segregationists who opposed them, and the ways in which law shaped both of these efforts. Inspired by the National Association for the Advancement of Colored People?s (NAACP) campaign to implement Brown, blacks sought access to their constitutional rights in the state?s federal courts, where they were ultimately able to force substantial compliance. Whites, however, converted massive resistance into an ostensibly colorblind movement to preserve ?law and order,? while at the same time taking effective measures to preserve segregation and white privilege. As soon as the NAACP implementation campaign began, self-styled moderate segregationists began to abandon self-defeating forms of resistance and to fashion a creed of ?law and order.? When black activists achieved a litigious breakthrough in 1963, the developing creed allowed segregationists to reject violence and outright defiance of the law, to accept token desegregation, and to begin to stake their own claims to constitutional rights ? all without forcing them to repudiate segregation and white supremacy. When continuing litigation forced school systems to abandon ineffective ?freedom of choice? desegregation plans for compulsory pupil assignment plans, these so-called moderates began using their individual rights language to justify flight to private segregationist academies, independent suburban school systems, and otherwise safely white school districts. Political and legal historians have underappreciated the deep and broad roots of the narrative of white racial innocence, the endurance of massive resistance, and the pivotal role which school desegregation litigation played in channeling both into a broader movement towards modern conservatism. The cases considered here ? particularly the statewide Lee v. Macon County Board of Education case ? demonstrate the effectiveness of litigation in bringing down official state and local barriers to equal opportunity for minorities and in enforcing constitutional law. But they also showcase the limits of litigation in effecting social justice in the face of powerfully constructed narratives of resistance seemingly built upon the nation?s founding principles.

Published
2014
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24. Boston's Oldest Buildings and Where to Find Them.

Author

Bagley, Joseph M.

Subjects
BUILT environment
Abstract

Used as a walking guide, an architectural primer, or just a delightful read, this book is a wonderful resource for anyone interested in history, Boston's built environment, and the stories about Bostonians that are frequently left untold." "Bagley dug deep into deeds, probate records, ancestry, military data, and historic maps to uncover the city's 50 oldest buildings-from homes and churches to warehouses and restaurants-and the stories they hold. [Extracted from the article]

Published
2022

27. School Desegregation, Law and Order, and Litigating Social Justice in Alabama, 1954-1973

Author

Bagley, Joseph Mark

Subjects
American politics, Modern conservatism, Civil rights, Law, Education, Segregation
Abstract

This study examines the legal struggle over school desegregation in Alabama in the two decades following the Supreme Court’s Brown v. Board decision of 1954. It seeks to better understand the activists who mounted a litigious assault on segregated education, the segregationists who opposed them, and the ways in which law shaped both of these efforts. Inspired by the National Association for the Advancement of Colored People’s (NAACP) campaign to implement Brown, blacks sought access to their constitutional rights in the state’s federal courts, where they were ultimately able to force substantial compliance. Whites, however, converted massive resistance into an ostensibly colorblind movement to preserve “law and order,” while at the same time taking effective measures to preserve segregation and white privilege. As soon as the NAACP implementation campaign began, self-styled moderate segregationists began to abandon self-defeating forms of resistance and to fashion a creed of “law and order.” When black activists achieved a litigious breakthrough in 1963, the developing creed allowed segregationists to reject violence and outright defiance of the law, to accept token desegregation, and to begin to stake their own claims to constitutional rights – all without forcing them to repudiate segregation and white supremacy. When continuing litigation forced school systems to abandon ineffective “freedom of choice” desegregation plans for compulsory pupil assignment plans, these so-called moderates began using their individual rights language to justify flight to private segregationist academies, independent suburban school systems, and otherwise safely white school districts. Political and legal historians have underappreciated the deep and broad roots of the narrative of white racial innocence, the endurance of massive resistance, and the pivotal role which school desegregation litigation played in channeling both into a broader movement towards modern conservatism. The cases considered here – particularly the statewide Lee v. Macon County Board of Education case – demonstrate the effectiveness of litigation in bringing down official state and local barriers to equal opportunity for minorities and in enforcing constitutional law. But they also showcase the limits of litigation in effecting social justice in the face of powerfully constructed narratives of resistance seemingly built upon the nation’s founding principles.

Published
2014

28. A Meaningful Reality: The Integration of the Opelika, Alabama City School System, 1965-1972

Author

Bagley, Joseph

Subjects
History
Abstract

This thesis chronicles and analyzes the integration of the Opelika city school system from the institution of the freedom of choice method of desegregation in 1965 to the court-ordered total integration of the system in 1972. Opelika maintained a de jure segregated school system until forced to follow desegregation guidelines set forth by the United States Department of Health, Education, and Welfare. The system was added as a defendant in Lee vs. Macon County Board of Education in 1967, from which point the school board followed the court orders of federal district court judge Frank M. Johnson until it achieved total integration of the student body through forced assignment in 1972. In the course of narrating the events of this pivotal period in Opelika’s history, this thesis devotes particular attention to the actions of the local board of education, the role of community leaders, the fate of black schools, white flight to segregationist academies, and the state of the system today. It also seeks to situate Opelika within a larger historiographical context by noting how the city’s history of public school segregation both mirrored and deviated from patterns of school desegregation elsewhere in the South. Opelika’s transition from a segregated system to an integrated one was largely a success, but the legacy of Brown v. Board is far from determined.

Published
2007

29. Developing a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study

Author

Sinan Khadhouri, Kevin M. Gallagher, Kenneth R. MacKenzie, Taimur T. Shah, Chuanyu Gao, Sacha Moore, Eleanor F. Zimmermann, Eric Edison, Matthew Jefferies, Arjun Nambiar, Thineskrishna Anbarasan, Miles P. Mannas, Taeweon Lee, Giancarlo Marra, Juan Gómez Rivas, Gautier Marcq, Mark A. Assmus, Taha Uçar, Francesco Claps, Matteo Boltri, Giuseppe La Montagna, Tara Burnhope, Nkwam Nkwam, Tomas Austin, Nicholas E. Boxall, Alison P. Downey, Troy A. Sukhu, Marta Antón-Juanilla, Sonpreet Rai, Yew-Fung Chin, Madeline Moore, Tamsin Drake, James S.A. Green, Beatriz Goulao, Graeme MacLennan, Matthew Nielsen, John S. McGrath, Veeru Kasivisvanathan, Aasem Chaudry, Abhishek Sharma, Adam Bennett, Adnan Ahmad, Ahmed Abroaf, Ahmed Musa Suliman, Aimee Lloyd, Alastair McKay, Albert Wong, Alberto Silva, Alexandre Schneider, Alison MacKay, Allen Knight, Alkiviadis Grigorakis, Amar Bdesha, Amy Nagle, Ana Cebola, Ananda Kumar Dhanasekaran, Andraž Kondža, André Barcelos, Andrea Benedetto Galosi, Andrea Ebur, Andrea Minervini, Andrew Russell, Andrew Webb, Ángel García de Jalón, Ankit Desai, Anna Katarzyna Czech, Anna Mainwaring, Anthony Adimonye, Arighno Das, Arnaldo Figueiredo, Arnauld Villers, Artur Leminski, Arvinda Chippagiri, Asim Ahmed Lal, Asıf Yıldırım, Athanasios Marios Voulgaris, Audrey Uzan, Aye Moh Moh Oo, Ayman Younis, Bachar Zelhof, Bashir Mukhtar, Ben Ayres, Ben Challacombe, Benedict Sherwood, Benjamin Ristau, Billy Lai, Brechtje Nellensteijn, Brielle Schreiter, Carlo Trombetta, Catherine Dowling, Catherine Hobbs, Cayo Augusto Estigarribia Benitez, Cédric Lebacle, Cherrie Wing Yin Ho, Chi-Fai Ng, Chloe Mount, Chon Meng Lam, Chris Blick, Christian Brown, Christopher Gallegos, Claire Higgs, Clíodhna Browne, Conor McCann, Cristina Plaza Alonso, Daniel Beder, Daniel Cohen, Daniel Gordon, Daniel Wilby, Danny Gordon, David Hrouda, David Hua Wu Lau, Dávid Karsza, David Mak, David Martin-Way, Denula Suthaharan, Dhruv Patel, Diego M Carrion, Donald Nyanhongo, Edward Bass, Edward Mains, Edwin Chau, Elba Canelon Castillo, Elizabeth Day, Elsayed Desouky, Emily Gaines, Emma Papworth, Emrah Yuruk, Enes Kilic, Eoin Dinneen, Erika Palagonia, Evanguelos Xylinas, Faizan Khawaja, Fernando Cimarra, Florian Bardet, Francesca Kum, Francesca Peters, Gábor Kovács, Geroge Tanasescu, Giles Hellawell, Giovanni Tasso, Gitte Lam, Giuseppe Pizzuto, Gordan Lenart, Günal Özgür, Hai Bi, Hannah Lyons, Hannah Warren, Hashim Ahmed, Helen Simpson, Helena Burden, Helena Gresty, Hernado Rios Pita, Holly Clarke, Hosam Serag, Howard Kynaston, Hugh Crawford-Smith, Hugh Mostafid, Hugo Otaola-Arca, Hui Fen Koo, Ibrahim Ibrahim, Idir Ouzaid, Ignacio Puche-Sanz, Igor Tomašković, Ilker Tinay, Iqbal Sahibzada, Isaac Thangasamy, Iván Revelo Cadena, Jacques Irani, Jakub Udzik, James Brittain, James Catto, James Green, James Tweedle, Jamie Borrego Hernando, Jamie Leask, Jas Kalsi, Jason Frankel, Jason Toniolo, Jay D. Raman, Jean Courcier, Jeevan Kumaradeevan, Jennifer Clark, Jennifer Jones, Jeremy Yuen-Chun Teoh, John Iacovou, John Kelly, John P. Selph, Jonathan Aning, Jon Deeks, Jonathan Cobley, Jonathan Olivier, Jonny Maw, José Antonio Herranz-Yagüe, Jose Ignacio Nolazco, Jose Manuel Cózar-Olmo, Joseph Bagley, Joseph Jelski, Joseph Norris, Joseph Testa, Joshua Meeks, Juan Hernandez, Juan Luis Vásquez, Karen Randhawa, Karishma Dhera, Katarzyna Gronostaj, Kathleen Houlton, Kathleen Lehman, Kathryn Gillams, Kelvin Adasonla, Kevin Brown, Kevin Murtagh, Kiki Mistry, Kim Davenport, Kosuke Kitamura, Laura Derbyshire, Laurence Clarke, Lawrie Morton, Levin Martinez, Louise Goldsmith, Louise Paramore, Luc Cormier, Lucio Dell'Atti, Lucy Simmons, Luis Martinez-Piñeiro, Luis Rico, Luke Chan, Luke Forster, Lulin Ma, Maria Camacho Gallego, Maria José Freire, Mark Emberton, Mark Feneley, Marta Viridiana Muñoz Rivero, Matea Pirša, Matteo Tallè, Matthew Crockett, Matthew Liew, Matthew Trail, Max Peters, Meghan Cooper, Meghana Kulkarni, Michael Ager, Ming He, Mo Li, Mohamed Omran Breish, Mohamed Tarin, Mohammed Aldiwani, Mudit Matanhelia, Muhammad Pasha, Mustafa Kaan Akalın, Nasreen Abdullah, Nathan Hale, Neha Gadiyar, Neil Kocher, Nicholas Bullock, Nicholas Campain, Nicola Pavan, Nihad Al-Ibraheem, Nikita Bhatt, Nishant Bedi, Nitin Shrotri, Niyati Lobo, Olga Balderas, Omar Kouli, Otakar Capoun, Pablo Oteo Manjavacas, Paolo Gontero, Paramananthan Mariappan, Patricio Garcia Marchiñena, Paul Erotocritou, Paul Sweeney, Paula Planelles, Peter Acher, Peter C. Black, Peter K Osei-Bonsu, Peter Østergren, Peter Smith, Peter-Paul Michiel Willemse, Piotr L. Chlosta, Qurrat Ul Ain, Rachel Barratt, Rachel Esler, Raihan Khalid, Ray Hsu, Remigiusz Stamirowski, Reshma Mangat, Ricardo Cruz, Ricky Ellis, Robert Adams, Robert Hessell, Robert J.A. Oomen, Robert McConkey, Robert Ritchie, Roberto Jarimba, Rohit Chahal, Rosado Mario Andres, Rosalyn Hawkins, Rotimi David, Rustom P. Manecksha, Sachin Agrawal, Syed Sami Hamid, Samuel Deem, Sanchia Goonewardene, Satchi Kuchibhotla Swami, Satoshi Hori, Shahid Khan, Shakeel Mohammud Inder, Shanthi Sangaralingam, Shekhar Marathe, Sheliyan Raveenthiran, Shigeo Horie, Shomik Sengupta, Sian Parson, Sidney Parker, Simon Hawlina, Simon Williams, Simone Mazzoli, Slawomir Grzegorz Kata, Sofia Pinheiro Lopes, Sónia Ramos, Sophie Rintoul-Hoad, Sorcha O'Meara, Steve Morris, Stacey Turner, Stefano Venturini, Stephanos Almpanis, Steven Joniau, Sunjay Jain, Susan Mallett, Sven Nikles, null Shahzad, Sylvia Yan, Tarq Toma, Teresa Cabañuz Plo, Thierry Bonnin, Tim Muilwijk, Tim Wollin, Timothy Shun Man Chu, Timson Appanna, Tom Brophy, Tom Ellul, Tomaž Smrkolj, Tracey Rowe, Troy Sukhu, Trushar Patel, Tullika Garg, Turhan Çaşkurlu, Uros Bele, Usman Haroon, Víctor Crespo-Atín, Victor Parejo Cortes, Victoria Capapé Poves, Vincent Gnanapragasam, Vineet Gauhar, Vinnie During, Vivek Kumar, Vojtech Fiala, Wasim Mahmalji, Wayne Lam, Yew Fung Chin, Yigit Filtekin, Yih Chyn Phan, Youssed Ibrahim, Zachary A Glaser, Zainal Adwin Abiddin, Zijian Qin, Zsuzsanna Zotter, Zulkifli Zainuddin, Khadhouri, Sinan, Gallagher, Kevin M., Mackenzie, Kenneth R., Shah, Taimur T., Gao, Chuanyu, Moore, Sacha, Zimmermann, Eleanor F., Edison, Eric, Jefferies, Matthew, Nambiar, Arjun, Anbarasan, Thineskrishna, Mannas, Miles P., Lee, Taeweon, Marra, Giancarlo, Gómez Rivas, Juan, Marcq, Gautier, Assmus, Mark A., Uçar, Taha, Claps, Francesco, Boltri, Matteo, La Montagna, Giuseppe, Burnhope, Tara, Nkwam, Nkwam, Austin, Toma, Boxall, Nicholas E., Downey, Alison P., Sukhu, Troy A., Antón-Juanilla, Marta, Rai, Sonpreet, Chin, Yew-Fung, Moore, Madeline, Drake, Tamsin, Green, James S. A., Goulao, Beatriz, Maclennan, Graeme, Nielsen, Matthew, Mcgrath, John S., Kasivisvanathan, Veeru, Chaudry, Aasem, Sharma, Abhishek, Bennett, Adam, Ahmad, Adnan, Abroaf, Ahmed, Suliman, Ahmed Musa, Lloyd, Aimee, Mckay, Alastair, Wong, Albert, Silva, Alberto, Schneider, Alexandre, Mackay, Alison, Knight, Allen, Grigorakis, Alkiviadi, Bdesha, Amar, Nagle, Amy, Cebola, Ana, Dhanasekaran, Ananda Kumar, Kondža, Andraž, Barcelos, André, Galosi, Andrea Benedetto, Ebur, Andrea, Minervini, Andrea, Russell, Andrew, Webb, Andrew, de Jalón, Ángel García, Desai, Ankit, Czech, Anna Katarzyna, Mainwaring, Anna, Adimonye, Anthony, Das, Arighno, Figueiredo, Arnaldo, Villers, Arnauld, Leminski, Artur, Chippagiri, Arvinda, Lal, Asim Ahmed, Yıldırım, Asıf, Voulgaris, Athanasios Mario, Uzan, Audrey, Oo, Aye Moh Moh, Younis, Ayman, Zelhof, Bachar, Mukhtar, Bashir, Ayres, Ben, Challacombe, Ben, Sherwood, Benedict, Ristau, Benjamin, Lai, Billy, Nellensteijn, Brechtje, Schreiter, Brielle, Trombetta, Carlo, Dowling, Catherine, Hobbs, Catherine, Benitez, Cayo Augusto Estigarribia, Lebacle, Cédric, Ho, Cherrie Wing Yin, Ng, Chi-Fai, Mount, Chloe, Lam, Chon Meng, Blick, Chri, Brown, Christian, Gallegos, Christopher, Higgs, Claire, Browne, Clíodhna, Mccann, Conor, Plaza Alonso, Cristina, Beder, Daniel, Cohen, Daniel, Gordon, Daniel, Wilby, Daniel, Gordon, Danny, Hrouda, David, Lau, David Hua Wu, Karsza, Dávid, Mak, David, Martin-Way, David, Suthaharan, Denula, Patel, Dhruv, Carrion, Diego M, Nyanhongo, Donald, Bass, Edward, Mains, Edward, Chau, Edwin, Canelon Castillo, Elba, Day, Elizabeth, Desouky, Elsayed, Gaines, Emily, Papworth, Emma, Yuruk, Emrah, Kilic, Ene, Dinneen, Eoin, Palagonia, Erika, Xylinas, Evanguelo, Khawaja, Faizan, Cimarra, Fernando, Bardet, Florian, Kum, Francesca, Peters, Francesca, Kovács, Gábor, Tanasescu, Geroge, Hellawell, Gile, Tasso, Giovanni, Lam, Gitte, Pizzuto, Giuseppe, Lenart, Gordan, Özgür, Günal, Bi, Hai, Lyons, Hannah, Warren, Hannah, Ahmed, Hashim, Simpson, Helen, Burden, Helena, Gresty, Helena, Rios Pita, Hernado, Clarke, Holly, Serag, Hosam, Kynaston, Howard, Crawford-Smith, Hugh, Mostafid, Hugh, Otaola-Arca, Hugo, Koo, Hui Fen, Ibrahim, Ibrahim, Ouzaid, Idir, Puche-Sanz, Ignacio, Tomašković, Igor, Tinay, Ilker, Sahibzada, Iqbal, Thangasamy, Isaac, Cadena, Iván Revelo, Irani, Jacque, Udzik, Jakub, Brittain, Jame, Catto, Jame, Green, Jame, Tweedle, Jame, Hernando, Jamie Borrego, Leask, Jamie, Kalsi, Ja, Frankel, Jason, Toniolo, Jason, Raman, Jay D., Courcier, Jean, Kumaradeevan, Jeevan, Clark, Jennifer, Jones, Jennifer, Teoh, Jeremy Yuen-Chun, Iacovou, John, Kelly, John, Selph, John P., Aning, Jonathan, Deeks, Jon, Cobley, Jonathan, Olivier, Jonathan, Maw, Jonny, Herranz-Yagüe, José Antonio, Nolazco, Jose Ignacio, Cózar-Olmo, Jose Manuel, Bagley, Joseph, Jelski, Joseph, Norris, Joseph, Testa, Joseph, Meeks, Joshua, Hernandez, Juan, Vásquez, Juan Lui, Randhawa, Karen, Dhera, Karishma, Gronostaj, Katarzyna, Houlton, Kathleen, Lehman, Kathleen, Gillams, Kathryn, Adasonla, Kelvin, Brown, Kevin, Murtagh, Kevin, Mistry, Kiki, Davenport, Kim, Kitamura, Kosuke, Derbyshire, Laura, Clarke, Laurence, Morton, Lawrie, Martinez, Levin, Goldsmith, Louise, Paramore, Louise, Cormier, Luc, Dell'Atti, Lucio, Simmons, Lucy, Martinez-Piñeiro, Lui, Rico, Lui, Chan, Luke, Forster, Luke, Ma, Lulin, Gallego, Maria Camacho, Freire, Maria José, Emberton, Mark, Feneley, Mark, Rivero, Marta Viridiana Muñoz, Pirša, Matea, Tallè, Matteo, Crockett, Matthew, Liew, Matthew, Trail, Matthew, Peters, Max, Cooper, Meghan, Kulkarni, Meghana, Ager, Michael, He, Ming, Li, Mo, Omran Breish, Mohamed, Tarin, Mohamed, Aldiwani, Mohammed, Matanhelia, Mudit, Pasha, Muhammad, Akalın, Mustafa Kaan, Abdullah, Nasreen, Hale, Nathan, Gadiyar, Neha, Kocher, Neil, Bullock, Nichola, Campain, Nichola, Pavan, Nicola, Al-Ibraheem, Nihad, Bhatt, Nikita, Bedi, Nishant, Shrotri, Nitin, Lobo, Niyati, Balderas, Olga, Kouli, Omar, Capoun, Otakar, Oteo Manjavacas, Pablo, Gontero, Paolo, Mariappan, Paramananthan, Marchiñena, Patricio Garcia, Erotocritou, Paul, Sweeney, Paul, Planelles, Paula, Acher, Peter, Black, Peter C., Osei-Bonsu, Peter K, Østergren, Peter, Smith, Peter, Willemse, Peter-Paul Michiel, Chlosta, Piotr L., Ul Ain, Qurrat, Barratt, Rachel, Esler, Rachel, Khalid, Raihan, Hsu, Ray, Stamirowski, Remigiusz, Mangat, Reshma, Cruz, Ricardo, Ellis, Ricky, Adams, Robert, Hessell, Robert, Oomen, Robert J. A., Mcconkey, Robert, Ritchie, Robert, Jarimba, Roberto, Chahal, Rohit, Andres, Rosado Mario, Hawkins, Rosalyn, David, Rotimi, Manecksha, Rustom P., Agrawal, Sachin, Hamid, Syed Sami, Deem, Samuel, Goonewardene, Sanchia, Swami, Satchi Kuchibhotla, Hori, Satoshi, Khan, Shahid, Mohammud Inder, Shakeel, Sangaralingam, Shanthi, Marathe, Shekhar, Raveenthiran, Sheliyan, Horie, Shigeo, Sengupta, Shomik, Parson, Sian, Parker, Sidney, Hawlina, Simon, Williams, Simon, Mazzoli, Simone, Grzegorz Kata, Slawomir, Pinheiro Lopes, Sofia, Ramos, Sónia, Rintoul-Hoad, Sophie, O'Meara, Sorcha, Morris, Steve, Turner, Stacey, Venturini, Stefano, Almpanis, Stephano, Joniau, Steven, Jain, Sunjay, Mallett, Susan, Nikles, Sven, Shahzad, Null, Yan, Sylvia, Toma, Tarq, Cabañuz Plo, Teresa, Bonnin, Thierry, Muilwijk, Tim, Wollin, Tim, Chu, Timothy Shun Man, Appanna, Timson, Brophy, Tom, Ellul, Tom, Smrkolj, Tomaž, Rowe, Tracey, Sukhu, Troy, Patel, Trushar, Garg, Tullika, Çaşkurlu, Turhan, Bele, Uro, Haroon, Usman, Crespo-Atín, Víctor, Parejo Cortes, Victor, Capapé Poves, Victoria, Gnanapragasam, Vincent, Gauhar, Vineet, During, Vinnie, Kumar, Vivek, Fiala, Vojtech, Mahmalji, Wasim, Lam, Wayne, Fung Chin, Yew, Filtekin, Yigit, Chyn Phan, Yih, Ibrahim, Youssed, Glaser, Zachary A, Abiddin, Zainal Adwin, Qin, Zijian, Zotter, Zsuzsanna, and Zainuddin, Zulkifli

Subjects
Renal cancer, Prostate cancer, Risk factors, Urology, Bladder cancer, Urothelial cancer, Risk factor, Urinary tract cancer, Haematuria, Risk Calculator
Abstract

Background: Patient factors associated with urinary tract cancer can be used to risk stratify patients referred with haematuria, prioritising those with a higher risk of cancer for prompt investigation. Objective: To develop a prediction model for urinary tract cancer in patients referred with haematuria. Design, setting, and participants: A prospective observational study was conducted in 10 282 patients from 110 hospitals across 26 countries, aged ≥16 yr and referred to secondary care with haematuria. Patients with a known or previous urological malignancy were excluded. Outcome measurements and statistical analysis: The primary outcomes were the presence or absence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC], and renal cancer). Mixed-effect multivariable logistic regression was performed with site and country as random effects and clinically important patient-level candidate predictors, chosen a priori, as fixed effects. Predictors were selected primarily using clinical reasoning, in addition to backward stepwise selection. Calibration and discrimination were calculated, and bootstrap validation was performed to calculate optimism. Results and limitations: The unadjusted prevalence was 17.2% (n = 1763) for bladder cancer, 1.20% (n = 123) for UTUC, and 1.00% (n = 103) for renal cancer. The final model included predictors of increased risk (visible haematuria, age, smoking history, male sex, and family history) and reduced risk (previous haematuria investigations, urinary tract infection, dysuria/suprapubic pain, anticoagulation, catheter use, and previous pelvic radiotherapy). The area under the receiver operating characteristic curve of the final model was 0.86 (95% confidence interval 0.85-0.87). The model is limited to patients without previous urological malignancy. Conclusions: This cancer prediction model is the first to consider established and novel urinary tract cancer diagnostic markers. It can be used in secondary care for risk stratifying patients and aid the clinician's decision-making process in prioritising patients for investigation. Patient summary: We have developed a tool that uses a person's characteristics to determine the risk of cancer if that person develops blood in the urine (haematuria). This can be used to help prioritise patients for further investigation.

Published
2022

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