Critical Analysis of the AUA 2020/2025 Microscopic Hematuria Guidelines to Predict Urothelial but Not Renal Cortical Neoplasms and Validation of the Individual Clinical Components in Risk Stratification for Urothelial Neoplasms but Not Renal Cortical

The AUA 2025 guidelines effectively stratify patients with MH into risk groups for urothelial cancer but not renal cortical neoplasms of any kind. Furthermore, the variables used in the construction of this model were also validated for urothelial cancers but not renal neoplasms. In this study, women older than 70 years have an incidence of urothelial cancer of 2.2%, suggesting that women older than 70 years should be considered high risk. The lack of predictive value for renal cortical neoplasms suggests areas for guideline realignment, specifically the type and goal of renal imaging.