Hematuria is prevalent in up to a third of the US population.1 Approximately 2% to 5% of patients with microscopic hematuria and 12% of patients with macroscopic or gross hematuria will be diagnosed with urinary tract cancer, most cases of which are superficial bladder tumors detected through cystoscopy.2 Screening asymptomatic persons for bladder cancer with urinalysis to detect microscopic hematuria is not recommended by the US Preventive Services Task Force because of insufficient evidence of the advantage of treatment of screen-detected bladder cancer, as well as insufficient data on the harms of screening for and evaluating hematuria.3 There are also no acceptable screening tests for renal cell carcinoma, the predominant cancer detected through imaging during the evaluation for hematuria. However, with the widespread use of urinalysis and high prevalence of hematuria, many patients are evaluated for incidental findings of hematuria.
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Bauer SR, Carroll PR, Grady D. Hematuria Practice Guidelines That Explicitly Consider Harms and Costs. JAMA Intern Med. Published online July 29, 2019179(10):1362–1364. doi:10.1001/jamainternmed.2019.2269
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