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Screening for Hematuria

Geoffrey Modest, MD
JAMA. 1990;263(13):1763-1764. doi:10.1001/jama.1990.03440130043012.
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To the Editor.—  The recent article by Woolhandler et al1 argues against routine urinalysis screening. However, it may be dangerous to draw conclusions and make recommendations with insufficient data.Woolhandler et al admit that there are "neither randomized, controlled trials nor case-control studies of [the significance of] hematuria or proteinuria in healthy, asymptomatic populations." In fact, only two "population-based studies"1 of adults older than 35 years in the literature were mentioned, one of Swedish men aged 21 to 69 years (without any workup done to determine the cause of the hematuria)2 and the other a retrospective chart review, not even a true population-based study, of Minnesota residents (without any standardized workup done for hematuria).3 Can we generalize these sparse data from the specific populations of Sweden and Minnesota to minorities in, for example, inner-city Boston, Mass?Bladder cancer is one of the principal potentially treatable findings


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