High-grade bladder cancer patients not getting recommended care

Nearly all patients with high-grade, noninvasive bladder cancer are not receiving the guideline-recommended care that would best protect them from recurrence-a finding characterized as alarming by researchers from the UCLA Jonsson Comprehensive Cancer Center.

In fact, out of the 4,545 bladder cancer patients included in the UCLA group’s study, only one received the comprehensive care recommended by the AUA and the National Comprehensive Cancer Network.

Receiving the recommended comprehensive care for high-grade bladder cancer is critical because it can significantly minimize the likelihood that patients will die from their cancer, said lead author Karim Chamie, MD.

"We were surprised by the findings in this study, particularly in an era when many suggest that doctors over-treat patients and do too much in the name of practicing defensive medicine," Dr. Chamie said. "This study suggests quite the contrary-that we don’t do enough for patients with bladder cancer. If this was a report card on bladder cancer care in America, I’d say we’re earning a failing grade."

Non-compliance with guideline-recommended care was primarily attributed to urologists. Senior author Mark S. Litwin, MD, MPH, said it’s not clear why physicians are not routinely following established guidelines for care.

"It is puzzling, because strong evidence supports those guidelines," Dr. Litwin said. "But this is a wake-up call to all physicians caring for patients with bladder cancer. We know definitively what constitutes high-quality care. Now we just need to make sure it happens."

Study findings were published online in Cancer (July 11, 2011).