Persistent UTI Symptoms May Signal Bladder Cancer

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May 21, 2015 -- Urinary tract infection symptoms that don’t improve with time or treatment could point to bladder cancer, a new study suggests.

That finding applies to both men and women, said lead researcher Kyle Richards, MD, from the University of Wisconsin-Madison, during a press conference at the American Urological Association 2015 Annual Meeting.

Awareness is especially important when it comes to women, he said, because bladder cancer is more commonly associated with men.

"A lot of primary care doctors who are [initially] seeing these patients [with persistent UTI symptoms] are less aware that bladder cancer is even a possibility in women," he said.

And he said that because the most common symptom of bladder cancer is blood in the urine, also called “hematuria,” UTI-like symptoms don’t always raise suspicion.

In their first-of-its-kind study, Richards and his colleagues looked at data on 9,326 men and 2,869 women who were diagnosed with blood in the urine or a UTI in the year before they were diagnosed with bladder cancer. The researchers found that bladder cancer diagnoses take longer and health outcomes are worse in men and women who have UTIs than in men with blood in the urine.

The average time from initial symptoms to bladder cancer diagnosis was longer in women than in men. A closer look at the data suggested that UTIs were the reason for this.

Richards said the delay in diagnosis in women is understandable because their urologic care is typically given by primary care doctors and Ob/Gyns. Women often don’t see a urologist until “much later in the process,” he said, while men are more likely to see one earlier.

Also, both men and women who had a UTI were more likely to have more-advanced cancer at diagnosis than men who had blood in the urine.

The take-home message? When there are persistent symptoms, "don't just chalk it up to urinary tract infection," said Tomas Griebling, MD, MPH, a urologist from the University of Kansas in Kansas City. There's a tendency to do so because they're so common, he said.

"The money and resources spent on UTIs eclipses everything else we do [in urologic diseases]," he said, including prostate and bladder cancer. And in the United States, "the numbers are astronomically higher" for UTIs.

Dr. Griebling reports financial relationships with Medtronic and Pfizer.

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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American Urological Association (AUA) 2015 Annual Meeting, New Orleans, May 15-19, 2015.

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