Individual research recommendation details

Recommendation ID

NG2/3

Question

In people with high-risk non-muscle-invasive bladder cancer, are these follow-up regimens equally
effective in terms of identification of progression, cost effectiveness and health-related quality of
life?
- Cystoscopic follow-up at 3, 6, 12, 18, 24, 36 and 48 months, and then annually, interspersed
with non-invasive urinary tests.
- Cystoscopic follow-up at 3, 6, 9, 12, 15, 18, 21, 24, 30, 36, 42 and 48 months, and then annually
thereafter.

Any explanatory notes
(if applicable)

Cystoscopy is currently the standard of care for follow-up of people with high-risk non-muscle-invasive bladder cancer. Regular cystoscopy may be associated with anxiety, procedural discomfort to the person and significant costs to the NHS. Urine tests based on a variety of technologies (including cytology, fluorescence in-situ hybridization [FISH] and proteomic platforms) can detect high-grade recurrence, raising the possibility that 1 or more of these tests could be used to reduce the frequency of cystoscopy. This could improve acceptability to patients and reduce costs to the NHS without increasing the risk of disease progression. There is a lack of evidence on the optimal frequency of follow-up and whether the frequency of cystoscopy follow-up can safely be reduced by substitution of urinary tests.

Source guidance details

Comes from guidance

Bladder cancer: diagnosis and management

Number

NG2

Date issued

February 2015

Other details