Persistent Asymptomatic Isolated Microscopic Hematuria in Adolescents is not Associated With an Increased Risk for Early Onset Urinary Tract Cancer - 09/11/22

Doi : 10.1016/j.urology.2022.06.048

Adi Leiba ^1,^2,^3,^4,^{^{#
Both authors contributed equally.}}, Sivan Zino ^3,^{^{#
Both authors contributed equally.}}, Avital Angel Korman ^2,³, Vladimir Rappaport ^2,³, Asaf Vivante ^5,⁶, Tamar Fishman ⁷, Gadi Shlomai ^5,^8,⁹, Tsahi T. Lerman ^5,¹⁰, Estela Derazne ⁵, Arnon Afek ^5,¹¹, Boris Fishman ^1,^5,^12,^⁎
¹ Israeli Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
² Division of Nephrology and Hypertension, Assuta Ashdod Hospital, Ashdod, Israel
³ Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel
⁴ Harvard Medical School, Cambridge, MA
⁵ Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
⁶ Pediatric Department B and Pediatric Nephrology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
⁷ Pharmacy Services, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
⁸ Internal Medicine D Department, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
⁹ Institute of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
¹⁰ Department of Internal Medicine F-Recanati, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
¹¹ Central Management, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
¹² Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel

^⁎Address correspondence to: Boris Fishman, M.D., M.P.H., Sheba Medical Center, Tel Hashomer, 2 Derech Sheba, Migdal Ishpuz, 3rd floor, Ramat Gan 5265601, Israel.2 Derech Sheba, Migdal Ishpuz, 3rd floorRamat Gan5265601Israel

Abstract

Objective

To elucidate the association between adolescent microscopic hematuria and early onset urothelial carcinoma and renal cell carcinoma.

Methods

Nationwide, population-based, retrospective cohort study using medical data of 970,366 adolescents aged 16 through 19 years (58.6% male) examined for fitness for military service between 1980 and 1997. Diagnoses of persistent isolated microscopic hematuria were given after thorough work up process excluding any other renal abnormalities. Incident cases of urothelial carcinoma and renal cell carcinoma diagnosed during the years of 1982-2012 were retrieved from the Israeli National Cancer Registry. Cox proportional hazards models were used to estimate the hazard ratio (HR) separately for urothelial carcinoma and renal cell carcinoma.

Results

During a cumulative follow-up of 22,115,629 person-years (median follow-up, 22.8), persistent isolated microscopic hematuria was diagnosed among 5509 (0.6%) adolescents. Urothelial carcinoma and renal cell carcinoma developed in 332 (3 among those with persistent isolated microscopic hematuria) and 292 (2) individuals, respectively. The adjusted HR for incident urothelial carcinoma among adolescents with isolated microscopic hematuria was 1.17 (95% CI, 0.38-3.66) and the adjusted HR for renal cell carcinoma was 1.02 (95% CI, 0.25-4.12).

Conclusion

Persistent asymptomatic isolated microscopic hematuria at adolescence was not associated with increased risk for urothelial carcinoma nor renal cell carcinoma.

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Abbreviations : ESRD, RCC, IDF, INCR, BMI, CT

Plan

MATERIALS AND METHODS

Study Population and Outcomes

Data Collection and Study Variables

Israeli National Cancer Registry

Statistical Analysis

RESULTS

Patients Characteristics

Microscopic Hematuria and Risk for Urothelial Carcinoma and RCC

DISCUSSION

	Financial Disclosure: The authors have no conflict of interests to report.
	Funding Support: No funding sources. No author has been paid to write this article by a pharmaceutical company or any other agency.
	Ethical approval:The study was approved by the IDF's ethics committee, who waived the requirement for informed consent since data were obtained from medical records without the participation of patients. Number of approval 1458201413.
	Prior presentation: An abstract of the preliminary results was presented in the ERA-EDTA conference 2020 Accepted