What is a primary concern when diagnosing any unexplained hematuria in older adults?

When diagnosing any unexplained hematuria in older adults, the primary concern is urothelial cancer. This demographic is at an increased risk for developing malignancies, including bladder and other urothelial cancers. Hematuria, which is the presence of blood in the urine, can be an early indicator of such cancers, especially in individuals over the age of 50.

In older populations, the likelihood of underlying serious conditions increases, making it crucial to investigate hematuria thoroughly. Urothelial carcinoma is notable for presenting with hematuria, often without accompanying significant urinary symptoms, making it a key aspect of the differential diagnosis. Recognizing the potential for cancer is essential for ensuring prompt evaluation and management, which can significantly influence the clinical outcome.

Other conditions listed, such as diabetes mellitus, bladder infection, and rhabdomyolysis, may also cause hematuria but are less commonly associated with unexplained cases in older adults compared to urothelial cancer, especially when no other symptoms are present.