Specimens signed out as AUC-H or SHGUC were identified from the archives of the study institution, which included periods of time before the use of the standardized Johns Hopkins Hospital template, during use of the Johns Hopkins Hospital template, and after institution of The Paris System for Reporting Urinary Cytology.
Approximately one-half of the specimens diagnosed as AUC-H were not investigated further when ordered by nonurologists. Patients with specimens diagnosed as AUC-H received fewer subsequent biopsies (14% vs 53%; P < .001) when the specimens were ordered by nonurologists versus urologists, despite having similar rates of high-grade urothelial carcinoma on follow-up biopsy (67% vs 66%). When specimens ordered by nonurologists were diagnosed as SHGUC, these patients received more follow-up (100%) compared with those whose specimens were diagnosed as AUC-H (44%; P < .001). Patients with specimens ordered by nonurologists also received more follow-up biopsies when these were diagnosed as suspicious (60%) compared with patients whose specimens were diagnosed as AUC-H (14%; P < .001).
Use of the word \"suspicious\" for the high-risk indeterminate category results in greater follow-up among nonurologists ordering UTC specimens. Cancer Cytopathol 2018;126:282-8. © 2018 American Cancer Society.