Evaluation of gender-based disparities in time from initial haematuria presentation to upper tract urothelial carcinoma diagnosis: analysis of a nationwide insurance claims database.
Meera R ChappidiMax KatesJeffrey J TosoianMichael H JohnsonNoah M HahnTrinity J BivalacquaPhillip M PierorazioPublished in: BJU international (2017)
A UTUC diagnosis was made >90 days after haematuria presentation in approximately one-third of patients. Men experienced a longer median interval from haematuria to UTUC 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-urologists. Future interventions should focus on development of non-invasive techniques to improve clinical risk stratification of patients presenting with haematuria and to educate practitioners, especially non-urologists, with regard to the importance of a thoughtful haematuria evaluation and the common mimickers of UTUC, to help reduce delays in diagnosis.
Keyphrases
- end stage renal disease
- primary care
- healthcare
- mental health
- emergency department
- chronic kidney disease
- physical activity
- ejection fraction
- type diabetes
- pregnant women
- health insurance
- case report
- adipose tissue
- prognostic factors
- pregnancy outcomes
- patient reported outcomes
- current status
- patient reported
- long term care