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Published on: January 12, 2017
Does antithrombotic use enable earlier diagnosis of bladder cancer? A brief institutional assessment
Yash B Shah1, Cassra B Clark1,2, Andrew Shumaker1
1Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Insights
Antithrombotic medication use did not affect bladder cancer stage at diagnosis. This study found no significant difference in non-muscle invasive bladder cancer versus muscle invasive bladder cancer rates between patients on antithrombotic medications and those not.
Area of Science:
- Urology
- Oncology
- Pharmacology
Background:
- Antithrombotic medications (ATMs) are associated with increased hematuria complications and bladder cancer diagnosis.
- Previous studies lacked data on the association between ATM use and bladder cancer stage at diagnosis.
- Understanding this association is crucial for early bladder cancer detection and management.
Purpose of the Study:
- To investigate the association between antithrombotic medication use and bladder cancer stage at diagnosis.
- To determine if ATM use influences the likelihood of non-muscle invasive bladder cancer (NMIBC) versus muscle invasive bladder cancer (MIBC) diagnosis.
Main Methods:
- Retrospective chart review of 844 patients diagnosed with bladder cancer.
- Patients were stratified based on antithrombotic medication use at the time of diagnosis.
- Descriptive statistics were used to compare bladder cancer staging between ATM users and non-users.
Main Results:
- Of 844 patients, 357 (42.3%) were taking antithrombotic medications.
- No statistically significant difference in the presentation rates of non-muscle invasive bladder cancer (NMIBC) was observed between patients on ATMs (81.2%) and those not on ATMs (77.8%).
- Subgroup analysis by ATM class also showed no significant differences in bladder cancer staging.
Conclusions:
- Antithrombotic medication use does not appear to facilitate an earlier diagnosis of bladder cancer.
- The presence of hematuria in patients on ATMs may indicate genitourinary pathology but does not correlate with earlier bladder cancer staging.
- Future research should explore hematuria characteristics, specific ATM types, and risk stratification for NMIBC.
Introduction:
Wallis et al (JAMA 2017) demonstrated use of antithrombotic medications (ATMs) is associated with increased prevalence of hematuria-related complications and subsequent bladder cancer diagnosis within 6 months. Stage of diagnosis was lacking in this highly publicized study. This study examined the association of ATM use on bladder cancer stage at the time of diagnosis.
Materials And Methods:
We completed a retrospective chart review of patients with a bladder cancer diagnosis at our institution. Patient demographics and bladder cancer work up information were assessed. Patients were stratified based on use of ATMs at time diagnosis. Descriptive statistics were completed to identify association between ATM use and stage of bladder cancer diagnosis, as stratified by non-muscle invasive bladder cancer (NMIBC) versus muscle invasive bladder cancer (MIBC).
Results:
A total of 1052 patient charts were reviewed. Eight hundred and forty-four were included and 208 excluded due to unavailability of diagnosis history. At diagnosis, 357 (42.3%) patients were taking ATMs. Patients on ATMs presented with NMIBC at similar rates as patients not taking ATMs (81.2% vs. 77.8%, p = 0.23). Subgroup analysis by ATM class similarly demonstrated no statistically significant differences in staging.
Conclusion:
While Wallis et al established that patients on blood thinners who present with hematuria are more likely to be diagnosed with genitourinary pathology, this factor does not appear to enable an earlier diagnosis of bladder cancer. Future study may assess hematuria at presentation (gross, microscopic), type of blood thinners, and low versus high risk NMIBC presentation.
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