The influence of urine cytology on our practice

Abstract

Objective:Bladder cancer is a common malignancy. It is ranked ninth among male population in Saudi Arabia. Urine cytology is used by some physicians routinely in the workup for diagnosis and follow-up of patients with urothelial cancer. Our objective is to determine whether urine cytology is still essential in the work up of suspected urothelial cancer patients and to measure its cost-effectiveness.Materials and Methods:We reviewed all urine cytology reports that were performed over a period of five years from 2006 to 2010 in the International Medical Center in Jeddah, Saudi Arabia. The medical records of patients with cytology reports of both positive for malignant cells and atypical cells suspicious of malignancy were retrospectively, studied for age, sex, nationality, cystoscopic findings, imaging results, and total cost.Results:A total of 563 urine cytology tests were done on 516 patients. Two patients were positive for malignant cell and 10 showed atypical cells suspicious of malignancy. All 12 patients underwent imaging and/or cystoscopy as part of their complete work up for hematuria. The two patients with positive cytology had a cystoscopic confirmation of bladder tumor. In the 10 patients with atypical cells, bladder tumor was identified in seven using cystoscopy and/or imaging. The mean age was 54.6±16 year (range 15-95). The total cost was 140,750 SR (37,533 USD) for a yield of 0.3% positive results and 2% atypical cytology.Conclusion:Routine urine cytology did not affect the diagnostic strategy for urothelial cancer. It should be only used in selected patients.

Evaluating quantity and quality of literature focusing on health economics and pharmacoeconomics in Gulf Cooperation Council countries

“…The majority of studies (n= 34) were published in international journals 14,[17][18][19]21,24,25,[27][28][29][30][35][36][37][38][39][40][41][42][43][45][46][47][48][50][51][52][53][54][57][58][59][60][61] and the remaining 15 studies were published in journals based in G.C.C. countries.…”

“…countries. 15,16,20,22,23,26,[31][32][33][34]44,49,55,56,62 Thirty seven studies were published in medical journals, [14][15][16][17][18][19][20][22][23][24][25][26][28][29][30][31][32][33]36,38,40,41,44,46,49,50,[52][53][54][55][56][57][58][59][60][61][62] 7 in non-medical journals…”

“…The mean (SD) number of authors per study was 4.20 (2.97) (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], in 45 studies the main authors were residing in the same country of study [14][15][16][17][18][19][20][21][22][23][24]26,[28][29][30][31][32]61,62 and only in 4 studies the main authors were residing in countries outside the G.C.C. 25,27,35,60 ; these included Canada, 25 USA , 27 UK 35 and Poland.…”

The pattern of urine cytology in a tertiary health care facility Northwest Nigeria

“…It involves microscopic evaluation of morphologic features of shed urothelial cells. 1 It is used in conjunction with cystoscopy and biopsy as standard for initial evaluation of patients suspected to be having bladder cancer. The diagnostic potential of urine cytology lies in its high specificity which ranges between 58% to 95%, however the sensitivity is not that impressive which is reported to be in the range of 48% to 80%.…”

“…9 It is recommended by the American Urology Association that voided urine cytology should be carried out in all patients with asymptomatic haematuria who belong to higher risk group and should be considered as first line option in patients who belong to low risk group. 1 Over the years, several urothelial cancer biomarkers have been developed in order to complement or replace urinary cytology. Most of these biomarkers have had adequate sensitivity but urine cytology still has better specificity when compared with these emerging tumour markers.…”