{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:24:48Z","timestamp":1765887888088,"version":"build-2065373602"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,5,17]],"date-time":"2017-05-17T00:00:00Z","timestamp":1494979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,9]]},"abstract":"\n Objective<\/jats:title>\n \n To investigate the length of time from initial haematuria presentation to upper tract urothelial carcinoma (\n UTUC<\/jats:styled-content>\n ) diagnosis and the effect of gender on this duration.\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n Patients with haematuria claims in the year prior to\n UTUC<\/jats:styled-content>\n diagnosis were identified from the MarketScan database (2010\u20132014). Delayed diagnosis was defined as >90 days from haematuria presentation to\n UTUC<\/jats:styled-content>\n diagnosis. Multivariable Poisson regression models were used to determine factors associated with delayed\n UTUC<\/jats:styled-content>\n diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 1 326 patients with\n UTUC<\/jats:styled-content>\n , 469 (35.4%) experienced delayed diagnosis. Men (\n n<\/jats:italic>\n = 866) had a longer median interval from haematuria to diagnosis than women (60 vs 49 days;\n P<\/jats:italic>\n = 0.04). In the multivariable model, male gender (relative risk [\n RR<\/jats:styled-content>\n ] 1.13, 95% confidence interval [\n CI<\/jats:styled-content>\n ] 0.95\u20131.34) was not associated with delayed diagnosis, while urinary tract infection (\n UTI<\/jats:styled-content>\n ;\n RR<\/jats:styled-content>\n 1.52, 95%\n CI<\/jats:styled-content>\n 1.32\u20131.76), nephrolithiasis (\n RR<\/jats:styled-content>\n 1.23, 95%\n CI<\/jats:styled-content>\n 1.06\u20131.44), new (\n RR<\/jats:styled-content>\n 1.37, 95%\n CI<\/jats:styled-content>\n 1.12\u20131.66) and recurrent prostate\u2010related diagnoses (\n RR<\/jats:styled-content>\n 1.61, 95%\n CI<\/jats:styled-content>\n 1.23\u20132.10) were. For men presenting to non\u2010urologists,\n UTI<\/jats:styled-content>\n (\n RR<\/jats:styled-content>\n 1.44, 95%\n CI<\/jats:styled-content>\n 1.22\u20131.71), nephrolithiasis (\n RR<\/jats:styled-content>\n 1.25 95%\n CI<\/jats:styled-content>\n 1.05\u20131.49), new (\n RR<\/jats:styled-content>\n 1.41, 95%\n CI<\/jats:styled-content>\n 1.12\u20131.78) and recurrent prostate\u2010related diagnoses (\n RR<\/jats:styled-content>\n 1.94, 95%\n CI<\/jats:styled-content>\n 1.45\u20132.58) were associated with delayed diagnosis; however, for men presenting to urologists, nephrolithiasis (\n RR<\/jats:styled-content>\n 1.08 95%\n CI<\/jats:styled-content>\n 0.78\u20131.49), new (\n RR<\/jats:styled-content>\n 1.15, 95%\n CI<\/jats:styled-content>\n 0.79\u20131.68) and recurrent prostate\u2010related diagnoses (\n RR<\/jats:styled-content>\n 1.17, 95%\n CI<\/jats:styled-content>\n 0.69\u20131.97) were not associated with delayed diagnosis, while\n UTI<\/jats:styled-content>\n diagnosis (\n RR<\/jats:styled-content>\n 1.74, 95%\n CI<\/jats:styled-content>\n 1.31\u20132.31) was still associated with delayed diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n A\n UTUC<\/jats:styled-content>\n diagnosis was made >90 days after haematuria presentation in approximately one\u2010third of patients. Men experienced a longer median interval from haematuria to\n UTUC<\/jats:styled-content>\n diagnosis compared with women, but male gender was not an independent predictor of delayed diagnosis. Benign diagnoses during haematuria evaluation were strongly associated with delayed diagnosis, especially among patients initially seen by non\u2010urologists. Future interventions should focus on development of non\u2010invasive techniques to improve clinical risk stratification of patients presenting with haematuria and to educate practitioners, especially non\u2010urologists, with regard to the importance of a thoughtful haematuria evaluation and the common mimickers of\n UTUC<\/jats:styled-content>\n , to help reduce delays in diagnosis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.13878","type":"journal-article","created":{"date-parts":[[2017,4,18]],"date-time":"2017-04-18T08:04:06Z","timestamp":1492502646000},"page":"377-386","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of gender\u2010based disparities in time from initial haematuria presentation to upper tract urothelial carcinoma diagnosis: analysis of a nationwide insurance claims database"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0636-9197","authenticated-orcid":false,"given":"Meera R.","family":"Chappidi","sequence":"first","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Kates","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey J.","family":"Tosoian","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael H.","family":"Johnson","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noah M.","family":"Hahn","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trinity J.","family":"Bivalacqua","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip M.","family":"Pierorazio","sequence":"additional","affiliation":[{"name":"James Buchanan Brady Urological Institute and Department of Urology Johns Hopkins University School of Medicine Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2015.232"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000107767.56680.f7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-010-0594-7"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.01.021"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-014-1311-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"7464","DOI":"10.18632\/oncotarget.10708","article-title":"Association between demographic factors and prognosis in urothelial carcinoma of the upper urinary tract: a systematic review and meta\u2010analysis","volume":"8","author":"Kim 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American Urological Association Web site. Available at:https:\/\/www.auanet.org\/education\/hematuria.cfm. Updated 2016. 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