Presentation Authors: Sinan Khadhouri*, Aberdeen, United Kingdom, Kevin M Gallagher, Edinburgh, United Kingdom, Kenneth R MacKenzie, Newcastle, United Kingdom, Taimur T Shah, London, United Kingdom, Chuanyu Gao, Peterborough, United Kingdom, Sacha Moore, Wrexham Maelor Hospital, United Kingdom, Eleanor Zimmerman, Weston-super-Mare, United Kingdom, Eric Edison, London, United Kingdom, Matthew Jefferies, Swansea, United Kingdom, Arjun K Nambiar, Newcastle, United Kingdom, John S McGrath, Exeter, United Kingdom, Veeru Kasivisvanathan, The IDENTIFY Study group, London, United Kingdom
Introduction: The IDENTIFY study aims to determine contemporary urinary tract cancer rates and diagnostic test performance in patients referred to secondary care with suspected urothelial cancer.
Methods: IDENTIFY is the largest ever prospective, global, multi-centre study of patients referred to secondary care, with or without haematuria, for the investigation of suspected urinary tract cancer. Patient demographics, symptoms, signs and diagnostic test results were recorded. Prevalence rates were calculated for each subtype of urological cancer and diagnostic test performances were analysed.
Results: Over 10,000 patient records were collected from 111 hospitals in 28 countries (Dec 2017 - Oct 2018). 63.3% presented with visible hematuria [VH], 31.6% with non-visible hematuria [NVH] and 5.1% without hematuria [NH]. The prevalence of bladder cancer [BC] overall was 14.2%; 18.1% in VH, 3.7% in NVH and 26.6% in NH. 81.5% of bladder cancers presented with VH. Upper tract urothelial cancer [UTUC] prevalence was 1%, renal cell carcinoma [RCC] 0.9% and prostate cancer 1.2%. BC and UTUC prevalence peaked in the 70-79 year age group and were more common in men. _x000D_
Variables significantly associated with BC included type of hematuria, age, smoking history, anticoagulation, storage urinary tract symptoms and having had >1 episode of VH (25.5%) vs. only 1 (17.9%). UTUC was significantly associated with type of hematuria, age, smoking and anticoagulation. The rate of BC found in those with culture proven urinary tract infection [UTIs] was 7.0%, which was significantly lower than in those without UTI (19.7%). The diagnostic performance of ultrasound [US] and Computed Tomography [CT] is given in Table 1.
Conclusions: IDENTIFY provides contemporary cancer detection rates in a worldwide population alongside diagnostic test performance for each cancer type. The detailed dataset will allow a personalised approach to hematuria investigations by developing predictive models to optimise cancer detection. This will also improve patient-doctor shared decision-making. These patient-specific pathways will reduce patient and healthcare resource burdens.
Source of Funding: Action Bladder Cancer UK