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One study conducted by Saarela et al reported an increased incidence of kidney cancer associated with type 2 diabetes mellitus (standardised incidence ratio = 1.42, 95% CI 1.37 to 1.47).1 Some of our ideas are shared with the readers. First, cancer usually has a prodromal phase, but it may be vague or non-specific, and it cannot easily be self-diagnosed by patients. Additionally, haematuria is an early feature of kidney cancer,2 but initially it may only be microhaematuria or non-visible haematuria. It is difficult to be self-diagnosed by patients. Only when it becomes visible haematuria, can it be discerned by patients.3 Clinically, it is not practical to perform urine analysis every day just for detecting haematuria. Thus, we cannot be sure of the onset date of haematuria. Second, hyperglycaemia always precedes the confirmed diagnosis of diabetes mellitus. Diabetes mellitus is a chronic condition with a long-term clinical course. It is difficult to check blood every day only for detecting hyperglycaemia. So, we also cannot be sure of …
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