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EDITORIAL COMMENT

  • Maximilian Pallauf
    Affiliations
    Departments of Urology and Oncology, the James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD

    Department of Urology, Paracelsus Medical University Salzburg, University Hospital Salzburg, Salzburg, Austria
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  • Nirmish Singla
    Correspondence
    Address correspondence to: Nirmish Singla M.D., M.S.C.S, The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287.
    Affiliations
    Departments of Urology and Oncology, the James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, MD
    Search for articles by this author
      Asymptomatic microhematuria (AMH) is a common finding, for which the etiologies are broad, including gynecologic, nephrologic, benign urologic conditions, and urinary tract cancers (UTC).
      • Jung H
      • Gleason JM
      • Loo RK
      • Patel HS
      • Slezak JM
      • Jacobsen SJ.
      Association of hematuria on microscopic urinalysis and risk of urinary tract cancer.
      The guideline definition of AMH and recommendations for its evaluation have changed throughout the last decade, relying now on a risk-stratified approach.
      • Barocas DA
      • Boorjian SA
      • Alvarez RD
      • et al.
      Microhematuria: AUA/SUFU Guideline.
      Omitting invasive investigations for young, low-risk patients aims to prevent harm and reduce healthcare costs.
      • Georgieva MV
      • Wheeler SB
      • Erim D
      • et al.
      Comparison of the harms, advantages, and costs associated with alternative guidelines for the evaluation of hematuria.
      ,
      • Gold SA
      • Kenigsberg AP
      • Lotan Y.
      Diagnostic and Cost Implications of the 2020 AUA Microhematuria Guidelines: Modeling Impact in a Large Public Health Care System.
      However, evidence of long-term patient follow-up is limited.
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      References

        • Jung H
        • Gleason JM
        • Loo RK
        • Patel HS
        • Slezak JM
        • Jacobsen SJ.
        Association of hematuria on microscopic urinalysis and risk of urinary tract cancer.
        J Urol. 2011; 185: 1698-1703
        • Barocas DA
        • Boorjian SA
        • Alvarez RD
        • et al.
        Microhematuria: AUA/SUFU Guideline.
        J Urol. 2020; 204: 778-786
        • Georgieva MV
        • Wheeler SB
        • Erim D
        • et al.
        Comparison of the harms, advantages, and costs associated with alternative guidelines for the evaluation of hematuria.
        JAMA Intern Med. 2019; 179: 1352-1362
        • Gold SA
        • Kenigsberg AP
        • Lotan Y.
        Diagnostic and Cost Implications of the 2020 AUA Microhematuria Guidelines: Modeling Impact in a Large Public Health Care System.
        J Urol. 2022; 207: 52-60
        • Fishman B.
        Persistent asymptomatic isolated microscopic hematuria in adolescents is not associated with an increased risk for early onset urinary tract cancer.
        Urology. 2022; 169: 29-34
        • Loo RK
        • Lieberman SF
        • Slezak JM
        • et al.
        Stratifying risk of urinary tract malignant tumors in patients with asymptomatic microscopic hematuria.
        Mayo Clin Proc. 2013; 88: 129-138
        • Khadhouri S
        • Gallagher KM
        • MacKenzie KR
        • et al.
        The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study.
        BJU Int. 2021; 128: 440-450
        • Cumberbatch MGK
        • Jubber I
        • Black PC
        • et al.
        Epidemiology of bladder cancer: a systematic review and contemporary update of risk factors in 2018.
        Eur Urol. 2018; 74: 784-795
        • Ghandour R
        • Freifeld Y
        • Singla N
        • Lotan Y.
        Evaluation of hematuria in a large public health care system.
        Bladder Cancer. 2019; 5: 119-129