Quality standard

Quality statement 4: Risk classification

Quality statement 4: Risk classification

Quality statement

Adults with newly diagnosed non‑muscle‑invasive bladder cancer have a risk classification of their cancer completed.

Rationale

Risk classification of non‑muscle‑invasive bladder cancer is used in multidisciplinary team discussions and in discussions with the person to help consider prognosis and decide treatment options.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements and written clinical protocols to ensure that adults with newly diagnosed non‑muscle‑invasive bladder cancer have a risk classification of their cancer completed.

Data source: Local data collection.

Process

Proportion of adults with newly diagnosed non‑muscle‑invasive bladder cancer who have a risk classification of their cancer completed.

Numerator – the number in the denominator who have a risk classification of their cancer completed.

Denominator – the number of adults with a new diagnosis of non‑muscle‑invasive bladder cancer.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers (secondary care services) ensure that systems are in place for adults with newly diagnosed non‑muscle‑invasive bladder cancer to have a risk classification completed.

Healthcare professionals complete a risk classification for adults with newly diagnosed non‑muscle‑invasive bladder cancer.

Commissioners ensure that they commission services that complete a risk classification for adults with newly diagnosed non‑muscle‑invasive bladder cancer.

Adults with bladder cancer that has not grown into the muscle wall of the bladder have information about the likely future risk from their cancer, including the risk of it growing into the muscle wall, written in their notes when the cancer is first diagnosed. This information helps them and their doctors to decide the best treatment options.

Source guidance

Bladder cancer. NICE guideline NG2 (2015), recommendation 1.3.1

Definitions of terms used in this quality statement

Risk classification of non‑muscle‑invasive bladder cancer

Low risk

Urothelial cancer with any of:

  • solitary pTaG1 with a diameter of less than 3 cm

  • solitary pTaG2 (low grade) with a diameter of less than 3 cm

  • any papillary urothelial neoplasm of low malignant potential.

Intermediate risk

Urothelial cancer that is not low risk or high risk, including:

  • solitary pTaG1 with a diameter of more than 3 cm

  • multifocal pTaG1

  • solitary pTaG2 (low grade) with a diameter of more than 3 cm

  • multifocal pTaG2 (low grade)

  • pTaG2 (high grade)

  • any pTaG2 (grade not further specified)

  • any low-risk non-muscle-invasive bladder cancer recurring within 12 months of last tumour occurrence.

High risk

Urothelial cancer with any of:

  • pTaG3

  • pT1G2

  • pT1G3

  • pTis (Cis).

[NICE's guideline on bladder cancer, section 1.3]