Investigation and Detection of Urological Neoplasia in Patients Referred With Suspected Urinary Tract Cancer:
Investigation and Detection of Urological Neoplasia in Patients Referred With Suspected Urinary Tract Cancer:
Bladder cancer is common in the UK and can kill. A common sign of bladder cancer is blood in
 the urine (haematuria).

 GPs will refer to a specialist (Urologist) for further investigation of haematuria if they
 suspect cancer.

 Hospitals often have a 'blanket' approach for investigating patients with haematuria.
 IDENTIFY will collect data on patients having these tests across the UK and internationally,
 looking at any trends with an aim to create a personalised diagnostic approach for each
 patient. The data will give patients the ability to make informed decisions, as well as
 reducing unnecessary and potentially harmful tests.
IDENTIFY aims to be the largest contemporary study providing data on the utility of the
 current diagnostic pathway for bladder and upper urinary tract cancer in patients presenting
 with haematuria.

 It also aims to provide a contemporary evaluation of current urological practices and
 assessment of the prevalence of urinary tract cancers (bladder cancer, upper tract cancer,
 renal cancer) in patients with haematuria. This will allow us to recommend changes in cancer
 diagnosis pathways that may reduce the number of invasive procedures, reduce waste of
 resources and optimize use of the most appropriate tests. This will mean resources are spent
 effectively, allowing for early diagnosis and faster treatment pathways.

 An evaluation of the patient factors that predict urinary tract cancer, particularly
 high-risk disease, may allow clinicians to better recognise groups of patients that will
 benefit from invasive investigations and are more likely to benefit from prompt diagnosis and
 treatment. Upper tract urinary cancer is quite rare and difficult to diagnose. It requires a
 large patient cohort such as the IDENTIFY study in order to recognise associations with the
 diagnosis of this disease and optimize the way we diagnose it.

 Shared-decision making is extremely important in patients presenting with haematuria and the
 outcomes of IDENTIFY will allow a more personalized approach to the diagnosis of urinary
 tract cancer. For example, rather than a blanket approach in which all patients undergo
 flexible cystoscopy and one or more imaging tests, we will generate data that could offer
 patients information on the likelihood of a flexible cystoscopy or other test finding cancer
 for them, given their personal characteristics.

 IDENTIFY results are also hoped to help inform national and international guidelines on
 referral for haematuria.
Inclusion Criteria:

 -  Any patient referred with haematuria (visible and non-visible) undergoing cystoscopy

 -  Any patient referred without haematuria undergoing cystoscopy for the purpose of
 ruling out urothelial cancer suspected due to other symptoms (e.g. lower urinary tract
 symptoms, recurrent urinary tract symptoms, dysuria)

 Exclusion Criteria:

 -  Patients with a previous or known diagnosis of primary upper or lower urinary tract
 urothelial cancers (renal, ureteric, bladder, prostate, urethral and penile cancers)

 -  Patients with suspected recurrence of upper or lower urinary tract primary urothelial
 cancer (renal, ureteric, bladder, prostate, urethra and penile cancers)

 -  Patients undergoing flexible cystoscopy for a reason unrelated to ruling out urinary
 tract urothelial cancer