Risk factors associated with urinary tract cancer in patients referred with haematuria: Results from the IDENTIFY collaborative study
BAUS ePoster online library. Khadhouri S. 11/10/20; 304223; P12-5 Disclosure(s): No disclosures
Mr. Sinan Khadhouri
Mr. Sinan Khadhouri
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Risk factors associated with urinary tract cancer in patients referred with haematuria: Results from the IDENTIFY collaborative study

Khadhouri S1, Gallagher K2, MacKenzie K3, Shah T4, Gao C5, Moore S6, Zimmermann E7, Edison E8, Jefferies M9, Nambiar A10, McGrath J11, Kasivisvanathan V12, IDENTIFY Study Group13
1Aberdeen Royal Infirmary, United Kingdom, 2Western General Hospital, Edinburgh, United Kingdom, 3Sunderland Royal Hospital, United Kingdom, 4Charing Cross Hospital, London, United Kingdom, 5Addenbrookes Hospital, Cambridge, United Kingdom, 6Wrexham Maelor Hospital, United Kingdom, 7Torbay and South Devon NHS Foundation Trust, United Kingdom, 8North Middlesex Hospital, London, United Kingdom, 9Morriston Hospital, Swansea, United Kingdom, 10Freeman Hospital, Newcastle, United Kingdom, 11University of Exeter Medical School, United Kingdom, 12University College London Hospitals NHS Foundation Trust, United Kingdom, 13BURST Collaborative , London, United Kingdom

Introduction:
IDENTIFY is the largest global, prospective, observational study on patients referred to secondary care with haematuria. We aimed to determine clinical risk factors for bladder (BC) and upper urothelial tract cancer (UTUC).
Patients & Methods: Data was collected on patients referred to secondary care with newly suspected urinary tract cancer. Multilevel logistic models were used to assess established clinical risk factors for all cancers, then additional less-established risk factors for BC and UTUC.

Results:
There were 11,059 patients from 110 institutions in 26 countries. The prevalence rates of cancers were: BC 17.9% (n= 1951), UTUC 1.17% (n=128), RCC 0.98% (n=107), prostate cancer 1.14% (n=124). Our model showed that established clinical risk factors: visible haematuria (OR 3.4, CI 2.8-4.0, p<0.001), male sex (OR 1.3, CI 1.2-1.5, p<0.001), increasing age (OR 1.04, CI 1.03-1.05, p<0.001) and smoking history (OR 2.1, CI 1.9-2.4, p<0.001) were independently associated with a urinary tract cancer diagnosis. Table 1 shows the association of less established risk factors with bladder cancer. A high-risk occupation and more than one episode of haematuria were associated with an increased risk of BC. Voiding LUTs and previous haematuria investigations were associated with a reduced risk of BC. Flank pain was independently associated with UTUC (OR 3.6 CI 2.2-5.8, p<0.001).

Conclusions:
We have identified an association between previously poorly understood risk factors and the diagnosis of BC and UTUC which will be used as part of a risk calculator for cancer risk prediction and to personalise choice of investigations.
Risk factors associated with urinary tract cancer in patients referred with haematuria: Results from the IDENTIFY collaborative study

Khadhouri S1, Gallagher K2, MacKenzie K3, Shah T4, Gao C5, Moore S6, Zimmermann E7, Edison E8, Jefferies M9, Nambiar A10, McGrath J11, Kasivisvanathan V12, IDENTIFY Study Group13
1Aberdeen Royal Infirmary, United Kingdom, 2Western General Hospital, Edinburgh, United Kingdom, 3Sunderland Royal Hospital, United Kingdom, 4Charing Cross Hospital, London, United Kingdom, 5Addenbrookes Hospital, Cambridge, United Kingdom, 6Wrexham Maelor Hospital, United Kingdom, 7Torbay and South Devon NHS Foundation Trust, United Kingdom, 8North Middlesex Hospital, London, United Kingdom, 9Morriston Hospital, Swansea, United Kingdom, 10Freeman Hospital, Newcastle, United Kingdom, 11University of Exeter Medical School, United Kingdom, 12University College London Hospitals NHS Foundation Trust, United Kingdom, 13BURST Collaborative , London, United Kingdom

Introduction:
IDENTIFY is the largest global, prospective, observational study on patients referred to secondary care with haematuria. We aimed to determine clinical risk factors for bladder (BC) and upper urothelial tract cancer (UTUC).
Patients & Methods: Data was collected on patients referred to secondary care with newly suspected urinary tract cancer. Multilevel logistic models were used to assess established clinical risk factors for all cancers, then additional less-established risk factors for BC and UTUC.

Results:
There were 11,059 patients from 110 institutions in 26 countries. The prevalence rates of cancers were: BC 17.9% (n= 1951), UTUC 1.17% (n=128), RCC 0.98% (n=107), prostate cancer 1.14% (n=124). Our model showed that established clinical risk factors: visible haematuria (OR 3.4, CI 2.8-4.0, p<0.001), male sex (OR 1.3, CI 1.2-1.5, p<0.001), increasing age (OR 1.04, CI 1.03-1.05, p<0.001) and smoking history (OR 2.1, CI 1.9-2.4, p<0.001) were independently associated with a urinary tract cancer diagnosis. Table 1 shows the association of less established risk factors with bladder cancer. A high-risk occupation and more than one episode of haematuria were associated with an increased risk of BC. Voiding LUTs and previous haematuria investigations were associated with a reduced risk of BC. Flank pain was independently associated with UTUC (OR 3.6 CI 2.2-5.8, p<0.001).

Conclusions:
We have identified an association between previously poorly understood risk factors and the diagnosis of BC and UTUC which will be used as part of a risk calculator for cancer risk prediction and to personalise choice of investigations.
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