Surveillance for bladder cancer: the management of 4.8 million people

Objective To document the workload of bladder cancer surveillance on the British urologist, Methods Thirty-one consultant urologists serving a population of 4.8 million were sent postal questionnaires eliciting their views on the management of superficial bladder cancer. The number, type and outcome of cystoscopies performed over a 6-week period throughout the region was then assessed prospectively. Results One person in 1450 in the South-west region is undergoing follow-up for bladder cancer. Of the responding consultants, 36% would give a single dose of intravesical chemotherapy within 24 h of resection for a G1/2 pTa tumour and 84% would perform the first check cystoscopy at 3-4 months. Over the 6-week period of the study, 696 cystoscopies were performed; there was considerable variation among centres in the choice of cystoscopy type, with 3-80% being rigid cystoscopies. Overall, there was a positive finding in 31% of the assessments. Conclusion This study documents the practice of a significant number of UK urologists in the management of superficial bladder cancer. There are considerable variations among individuals in the type and timing of check cystoscopy.