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Table 2 Sensitivity and specificity of 'Macroscopic haematuria' and 'Increased urinary frequency' according to cancer diagnosis, with corresponding positive predictive values of urogenital cancer

From: Symptoms and signs of urogenital cancer in primary care

 

N

  

Sensitivity (A)

PPV (A)

   

Sensitivity (B)

Sensitivity (C)

Sensitivity (D)

All

Males

Females

All

95% CI

All

95% CI

Males

Females

All

95% CI

All

95% CI

All

95% CI

Bladder or renal cancer combined

46

36

10

            

Macroscopic haematuria and cancer (A):

5

4

1

10.9%

4.7–23.0

3.4%

1.5–7.7

4.9%

1.5%

      

Macroscopic haematuria and cancer (B):

13

11

2

      

28.3%

17.3–42.6

56.5%

42.2–69.8

60.9%

46.5–73.6

Bladder cancer

30

23

7

            

Macroscopic haematuria and cancer (A):

4

3

1

13.3%

5.3–29.7

2.7%

1.1–7.0

3.8%

1.5%

      

Macroscopic haematuria and cancer (B):

9

7

2

      

30.0%

16.7–47.9

63.3%

45.5–78.1

66.7%

48.8–80.1

Increased urinary frequency (A)

2

1

1

6.7%

1.9–21.3

 < 0.1%

         

Increased urinary frequency (B)

4

3

1

      

13.3%

5.3–29.7

    

Renal cancer

16

13

3

            

Macroscopic haematuria and cancer (A)

1

1

0

6.3%

1.1–28.3

0.7%

0.1–3.8

1.3%

       

Macroscopic haematuria and cancer (B)

4

4

0

      

25.0%

10.2–49.5

43.8%

23.1–66.8

50.0%

28.0–72.0

Prostate cancer

 

56

             

Macroscopic haematuria and cancer (A)

 

0

 

-

 

-

         

Macroscopic haematuria and cancer (B)

 

2

       

3.6%

1.0–12.1

5.4%

1.8–14.6

  

Increased urinary frequency (A)

 

2

 

3.6%

1.0–12.1

 < 0.1%

         

Increased urinary frequency (B)

 

18

       

32.1%

21.4–45.2

    

Uterine body cancer

  

14

            

Macroscopic haematuria and cancer (A)

  

1

7.1%

1.3–31.5

0.7%

0.1–3.8

 

1.5%

      

Macroscopic haematuria and cancer (B)

  

2

      

14.3%

4.0–40.0

    

'Increased urinary frequency' and cancer (A)

  

1

7.1%

1.3–31.5

   

 < 0.1%

      

'Increased urinary frequency' and cancer (B)

  

2

      

14.3%

4.0–40.0

    
  1. A: Number of patients, sensitivity, specificity and positive predictive value (PPV) based on consultation recordings
  2. B: Number of patients and sensitivity based on all recordings from consultation to diagnosis
  3. C: Sensitivity based on all recordings of Macroscopic haematuria and/or microscopic haematuria
  4. D: Sensitivity based on all recordings of Macroscopic haematuria plus microscopic haematuria and/or Anemia. For microscopic haematuria and 'Anemia', see below
  5. Specificity of 'Macroscopic haematuria' = 99.8% (95% CI 99.7–99.8), based on 143 patients with 'Macroscopic haematuria' without cancer, 61,019 patients with no 'Macroscopic haematuria' and no cancer
  6. Specificity of Increased urinary frequency = 98.8% (95% CI 98.7–98.9), based on 737 patients with 'Increased urinary frequency without cancer', 60,425 patients with no 'Increased urinary frequency' and no cancer
  7. Microscopic haematuria: 10 patients with bladder cancer and 3 patients with renal cancer and 1 patient with prostate cancer had a positive test, performed on clinical grounds, but without any mention of 'Macroscopic haematuria' at or after consultation
  8. Anemia': Recorded in 2 patients with bladder cancer and 2 patients with renal cancer and 0 patients with prostate cancer when there was no recording of 'Macroscopic haematuria' at or after consultation
  9. Of these, 2 patients (1 bladder, 1 kidney) also had microscopic haematuria
  10. For the calculation of specificity, all cancer patients reported by the GPs (n = 640) were excluded from the total number
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BMC Primary Care

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