Clinical features of bladder cancer in primary care

Abstract

BackgroundBladder cancer accounts for over 150 000 deaths worldwide. No screening is available, so diagnosis depends on investigations of symptoms. Of these, only visible haematuria has been studied in primary care. AimTo identify and quantify the features of bladder cancer in primary care. Design and settingCase-control study, using electronic medical records from UK primary care.

Quantifying the risk of multiple myeloma from symptoms reported in primary care patients: a large case–control study using electronic records

“…Testing for association used univariable and multivariable conditional logistic regression, performed in three stages. [17][18][19][20] The variable for hypergammaglobulinaemia was not included in the multivariable analyses as it could be considered an outcome variable rather than an explanatory variable. The first stage, univariable analysis, used a P-value threshold of 0.1 or below to identify candidate variables for multivariable analysis.…”

“…19,20,[22][23][24] This study, the largest reported, provided ample power to identify rare but potentially clinically relevant symptoms of myeloma, and allowed sub-analyses by age. The results are highly likely to be generalisable.…”

The NICE primary care referral guideline for suspected bladder or renal cancer

“…8 Moreover, the PPVs for visible haematuria were lower for renal cancer than for bladder cancer, and increased with repeat presentation in primary care (which the guideline development group considered a proxy for persistence) in both renal 13 and bladder cancer. 12 …”

“…3 In general, the PPVs for visible haematuria increased with age in both cancers [11][12][13] and tended to be higher in males than in females. 4,8 In males, this started at 1% below 45 years of age, increasing to 4.4% (45-54 years), 8.5% (55-64 years), 11.2% (65-74 years), 10.3% (75-84 years) and 9.2% (85 years or above).…”

“…The studies were conducted in the UK, 4,7,8,[11][12][13] the Netherlands, 9,10 Belgium 3 and the USA. 5,6 Follow-up was employed as a reference standard in all of the studies.…”