Open Access

ARTICLE

Does antithrombotic use enable earlier diagnosis of bladder cancer? A brief institutional assessment

Yash B. Shah¹, Cassra B. Clark^1,2, Andrew Shumaker¹, Andrew A. Denisenko¹, Samuel Alfonsi¹, Zachary Prebay¹, Joseph Schultz¹, Vasil Mico¹, Vishal Swaminathan¹, Roy Wang¹, James R. Mark¹, Edouard J. Trabulsi¹, Costas D. Lallas¹, Mark J. Mann¹, Hanan Goldberg³, Thenappan Chandrasekar^1,*

1 Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
2 Department of Urology, Penn State College of Medicine, Hershey, Pennsylvania, USA
3 Department of Urology, SUNY Upstate Medical University, Syracuse, New York, USA
* Address correspondence to current address: Dr. Thenappan Chandrasekar, Dept. of Urology, University of California, Davis, 4860 Y Street, Suite 3500, Sacramento, CA 95817 USA

Canadian Journal of Urology 2022, 29(6), 11391-11393.

Abstract

Introduction: Wallis et al (JAMA 2017) demonstrated use of antithrombotic medications (ATMs) is associated with increased prevalence of hematuria-related complications and subsequent bladder cancer diagnosis within 6 months. Stage of diagnosis was lacking in this highly publicized study. This study examined the association of ATM use on bladder cancer stage at the time of diagnosis.
Materials and methods: We completed a retrospective chart review of patients with a bladder cancer diagnosis at our institution. Patient demographics and bladder cancer work up information were assessed. Patients were stratified based on use of ATMs at time diagnosis. Descriptive statistics were completed to identify association between ATM use and stage of bladder cancer diagnosis, as stratified by non-muscle invasive bladder cancer (NMIBC) versus muscle invasive bladder cancer (MIBC).
Results: A total of 1052 patient charts were reviewed. Eight hundred and forty-four were included and 208 excluded due to unavailability of diagnosis history. At diagnosis, 357 (42.3%) patients were taking ATMs. Patients on ATMs presented with NMIBC at similar rates as patients not taking ATMs (81.2% vs. 77.8%, p = 0.23). Subgroup analysis by ATM class similarly demonstrated no statistically significant differences in staging.
Conclusion: While Wallis et al established that patients on blood thinners who present with hematuria are more likely to be diagnosed with genitourinary pathology, this factor does not appear to enable an earlier diagnosis of bladder cancer. Future study may assess hematuria at presentation (gross, microscopic), type of blood thinners, and low versus high risk NMIBC presentation.

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