Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
ECHO (Epidemiology of Cancer Healthcare and Outcomes) Research Group, Department of Behavioural Science and Health, University College London, London, UK.
Adv Ther. 2019 Jul;36(7):1778-1785. doi: 10.1007/s12325-019-00966-x. Epub 2019 May 17.
Bladder and kidney cancer are the 10th and 7th most common cancers in the United Kingdom (UK). They present with symptoms that are typically investigated via the same diagnostic pathway. However, diagnosing these cancers can be challenging, especially for kidney cancer, as many of the symptoms are non-specific and occur commonly in patients without cancer. Furthermore, the recognition and evaluation of these symptoms may differ because of the lack of supporting high-quality evidence to inform management, a problem also reflected in currently ambiguous guidelines. The majority of these two cancers are diagnosed following a referral from a general practitioner. In this article, we summarise current UK and United States (US) guidelines for investigating common symptoms of bladder and kidney cancer-visible haematuria, non-visible haematuria and urinary tract infections. Our article aims to support clinicians in recognising and investigating patients with symptoms of possible bladder and kidney cancer in a timely fashion. We discuss challenges during the diagnostic process and possible future interventions for improvement.
膀胱癌和肾癌是英国第 10 位和第 7 位最常见的癌症。它们的症状通常通过相同的诊断途径进行检查。然而,诊断这些癌症可能具有挑战性,特别是对于肾癌,因为许多症状是非特异性的,并且在没有癌症的患者中也很常见。此外,由于缺乏支持管理的高质量证据,这些症状的识别和评估可能会有所不同,目前指南也存在模糊不清的问题。这两种癌症中的大多数都是在全科医生转介后诊断出来的。在本文中,我们总结了英国和美国目前关于膀胱癌和肾癌常见症状(肉眼血尿、非肉眼血尿和尿路感染)的指南。我们的文章旨在支持临床医生及时识别和调查可能患有膀胱癌和肾癌症状的患者。我们讨论了诊断过程中的挑战以及可能的未来干预措施以进行改进。