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Invisible haematuria (urgent NICE referral guidance)

Last reviewed 2 Feb 2024

Haematuria

Symptom and Specific Features	Possible Cancer	Recommendation
Haematuria (visible and unexplained) either without urinary tract infection or that persists or recurs after successful treatment of urinary tract infection, 45 and over	Bladder or renal	Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks)

Symptom and Specific Features	Possible Cancer	Recommendation
Haematuria (non-visible and unexplained) with dysuria or raised white cell count on a blood test, 60 and over	Bladder	Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks)

Symptom and Specific Features	Possible Cancer	Recommendation
Haematuria (visible) with low haemoglobin levels or thrombocytosis or high blood glucose levels or unexplained vaginal discharge in women 55 and over	Endometrial	Consider a direct access ultrasound scan

Symptom and Specific Features	Possible Cancer	Recommendation
Haematuria (visible) in men	Prostrate	Consider a prostate-specific antigen (PSA) test and digital rectal examination

Note:

in 2005 NICE cancer guidance, unexplained microscopica haematuria (non-visible haematuria) in a patient 50 years or over was a 2 week referral. This guidance has not been repeated in the 2015 guidance but local implementation might mean that this guidance may be still employed when a local implementation of the NICE urological guidance is made

Reference:

NICE (June 2015). Suspected cancer: recognition and referral

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Invisible haematuria (urgent NICE referral guidance)

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