title: Stratifying patients with haematuria into high or low risk groups for bladder cancer: a novel clinical scoring system.
abstract: Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross- sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low risk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.
authors.affiliation: Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia E-mail : guanhee3479@yahoo.com.
authors.forename: Tan Guan
authors.initials: TG
authors.lastname: Hee
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
authors.forename: Ho Sue
authors.initials: HS
authors.lastname: Ann
authors.forename: Siti Nurhafizah
authors.initials: SN
authors.lastname: Hemdan
authors.forename: Lim Chun
authors.initials: LC
authors.lastname: Shen
authors.forename: Nurudin
authors.initials: N
authors.lastname: Al-Fahmi Abdul Galib
authors.forename: Praveen
authors.initials: P
authors.lastname: Singam
authors.forename: Christopher Ho
authors.initials: CH
authors.lastname: Chee Kong
authors.forename: Goh Eng
authors.initials: GE
authors.lastname: Hong
authors.forename: Badrulhisham
authors.initials: B
authors.lastname: Bahadzor
authors.forename: Zulkifli Md
authors.initials: ZM
authors.lastname: Zainuddin
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006417:Hematuria / Q000175:diagnosis* / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000652:urine*