{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T06:01:09Z","timestamp":1792389669050,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T00:00:00Z","timestamp":1535500800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008721","name":"University College London Hospitals NHS Foundation Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008721","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007568","name":"Urology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007568","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To determine the diagnostic accuracy of urinary cytology to diagnose bladder cancer and upper tract urothelial cancer (\n                      <jats:styled-content style=\"fixed-case\">UTUC<\/jats:styled-content>\n                      ) as well as the outcome of patients with a positive urine cytology and normal haematuria investigations in patients in a multicentre prospective observational study of patients investigated for haematuria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient and methods<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:styled-content style=\"fixed-case\">DETECT<\/jats:styled-content>\n                      I study (clinicaltrials.gov\n                      <jats:styled-content style=\"fixed-case\">NCT<\/jats:styled-content>\n                      02676180) recruited patients presenting with haematuria following referral to secondary case at 40 hospitals. All patients had a cystoscopy and upper tract imaging (renal bladder ultrasound [\n                      <jats:styled-content style=\"fixed-case\">RBUS<\/jats:styled-content>\n                      ] and\/ or\n                      <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>\n                      urogram [\n                      <jats:styled-content style=\"fixed-case\">CTU<\/jats:styled-content>\n                      ]). Patients, where urine cytology were performed, were sub\u2010analysed. The reference standard for the diagnosis of bladder cancer and\n                      <jats:styled-content style=\"fixed-case\">UTUC<\/jats:styled-content>\n                      was histological confirmation of cancer. A positive urine cytology was defined as a urine cytology suspicious for neoplastic cells or atypical cells.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 3\u00a0556 patients recruited, urine cytology was performed in 567 (15.9%) patients from nine hospitals. Median time between positive urine cytology and endoscopic tumour resection was 27 (\n                      <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n                      : 21.3\u201333.8) days. Bladder cancer was diagnosed in 39 (6.9%) patients and\n                      <jats:styled-content style=\"fixed-case\">UTUC<\/jats:styled-content>\n                      in 8 (1.4%) patients. The accuracy of urinary cytology for the diagnosis of bladder cancer and\n                      <jats:styled-content style=\"fixed-case\">UTUC<\/jats:styled-content>\n                      was: sensitivity 43.5%, specificity 95.7%, positive predictive value (\n                      <jats:styled-content style=\"fixed-case\">PPV<\/jats:styled-content>\n                      ) 47.6% and negative predictive value (\n                      <jats:styled-content style=\"fixed-case\">NPV<\/jats:styled-content>\n                      ) 94.9%. A total of 21 bladder cancers and 5\n                      <jats:styled-content style=\"fixed-case\">UTUC<\/jats:styled-content>\n                      were missed. Bladder cancers missed according to grade and stage were as follows: 4 (19%) were \u2265\n                      <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>\n                      2, 2 (9.5%) were G3\n                      <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>\n                      1, 10 (47.6%) were G3\/2\n                      <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>\n                      a and 5 (23.8%) were G1\n                      <jats:styled-content style=\"fixed-case\">pT<\/jats:styled-content>\n                      a. High\u2010risk cancer was confirmed in 8 (38%) patients. There was a marginal improvement in sensitivity (57.7%) for high\u2010risk cancers. When urine cytology was combined with imaging, the diagnostic performance improved with\n                      <jats:styled-content style=\"fixed-case\">CTU<\/jats:styled-content>\n                      (sensitivity 90.2%, specificity 94.9%) superior to\n                      <jats:styled-content style=\"fixed-case\">RBUS<\/jats:styled-content>\n                      (sensitivity 66.7%, specificity 96.7%). False positive cytology results were confirmed in 22 patients, of which 12 (54.5%) had further invasive tests and 5 (22.7%) had a repeat cytology. No cancer was identified in these patients during follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Urine cytology will miss a significant number of muscle\u2010invasive bladder cancer and high\u2010risk disease. Our results suggest that urine cytology should not be routinely performed as part of haematuria investigations. The role of urine cytology in select cases should be considered in the context of the impact of a false positive result leading to further potentially invasive tests conducted under general anaesthesia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.14459","type":"journal-article","created":{"date-parts":[[2018,7,13]],"date-time":"2018-07-13T02:10:37Z","timestamp":1531447837000},"page":"74-81","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Does urinary cytology have a role in haematuria investigations?"],"prefix":"10.1111","volume":"123","author":[{"given":"Wei Shen","family":"Tan","sequence":"first","affiliation":[{"name":"Division of Surgery and Interventional Science University College London London UK"},{"name":"Department of Urology University College London Hospital London 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