Stratifying Patients with Haematuria into High or Low Risk Groups for Bladder Cancer: a Novel Clinical Scoring System


Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This studyaimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groupsfor having bladder cancer to help clinicians decide which patients need more urgent assessment. This crosssectionalstudy included all adult patients referred for haematuria and subsequently undergoing full urologicalevaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the studypopulation were used to design the scoring system. Accuracy was determined by the area under the receiveroperating 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 malegender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinicalparameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicatedhigh risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designedin this study has the potential to help clinicians stratify patients who present with haematuria into high or lowr isk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.