SAN DIEGO—Researchers who studied a group of male veterans found, in contrast to prior reports, a higher incidence of bladder cancer cases in which patients presented solely with lower urinary tract symptoms (LUTS) and no hematuria, according to study findings presented at the American Urological Association annual meeting.

Using a database at the Atlanta Veteran Affairs Medical Center, Ryan Dobbs, a medical student at the Emory University School of Medicine in Atlanta, and collaborators identified 331 bladder cancer patients (all male). Of these, 14 (4.4%) presented solely with LUTS, a higher incidence than the 1%-2% incidence traditionally reported.

At median follow-up of 52 months (range 28 days to 128 months), five patients experienced recurrence after cystectomy and one experienced disease progression. At last follow-up, 11 patients were alive without recurrence; three patients had died, one from bladder cancer.

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“Although this patient population is highly enriched with patients who are smokers and have a history of chemical exposure, this study suggests that urologists should have a low threshold for evaluating patients with irritative symptoms for underlying bladder cancer,” the authors concluded in their study abstract.