Dipstick haematuria and bladder cancer in men over 60: results of a community study.

OBJECTIVE

To investigate the prevalence and relevance of dipstick haematuria in a group of men in the community.

DESIGN

Prospective study of elderly men invited to attend a health centre for urine screening as part of a health check.

SETTING

An inner city health centre in Leeds.

SUBJECTS

578 Of 855 men aged 60-85 responding to an invitation to participate.

INTERVENTIONS

The subjects had their urine tested with a dipstick (Multistix) for the presence of blood and then tested their urine once a week for the next 10 weeks. Those with one or more positive test results were offered full urological investigation.

MAIN OUTCOME MEASURE

The prevalence of urological disease in those subjects with dipstick haematuria.

RESULTS

78 Men (13%) had dipstick haematuria on a single test and a further 54 (9%) had evidence of dipstick haematuria when testing their urine once a week during a subsequent 10 week period. Investigation of 87 men disclosed urological disease in 45, including four with a bladder tumour and seven with epithelial dysplasia.

CONCLUSION

Dipstick haematuria is a common incidental finding in men over 60 and is associated with appreciable urological disease. The introduction of less invasive methods of investigation, particularly flexible cystoscopy and ultrasonography, has made investigation of these patients simple and safe and makes screening for bladder cancer in the community more feasible.