Harvard Men's Health Watch

Urine testing no longer routine

Q. At my last physical, the doctor did not collect urine for tests. Shouldn't that always be part of a physical?

A. Urinalysis used to be routine during check-ups, typically to test for traces of blood, protein, or sugar. This helped to identify people with hidden kidney disease or diabetes. Currently, most diseases that we can detect with urinalysis can be diagnosed much earlier with blood tests. Since blood testing is more common in doctors' offices now and urinalysis adds little new information, many doctors do not do it routinely.

Guidelines for doctors generally discourage routine urinalysis because it triggers too many false alarms for cancer. This is because finding a small amount of blood in the urine can be an early warning of bladder or kidney cancer, but it could also be one of several other common things, such as kidney stones or an enlarged prostate. Ruling out cancer may require invasive testing, which usually does not find cancer in the end anyway. As a result, urinalysis leads to a lot of unnecessary testing.

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