ASYMPTOMATIC MICROSCOPIC HEMATURIA - IS INVESTIGATION NECESSARY

Microscopic hematuria is common in asymptomatic adults, but the benefi t of screening the general population for blood in the urine has not b een established. On the other hand, most studies of referred patients with putatively asymptomatic microscopic hematuria have reported a 2-1 1% prevalence of urothelial malignancies, leading to the recommendatio n that all patients with microscopic hematuria be thoroughly investiga ted. Urinalysis is inexpensive and highly acceptable to the general po pulation, but is neither a sensitive, nor specific test, and has poor predictive value for urothelial malignancies, and nephrological diseas es. Furthermore the benefits of early detection of such diseases has n ot been established. We conclude that screening urinalysis cannot be r ecommended. Studies are needed to determine which constellation of fin dings primary physicians use to select patients for referral to center s with urological and nephrological expertise. (C) 1997 Elsevier Scien ce Inc.