Most bladder cancer patients don't get recommended care | UC Health

Only one out of 4,545 patients studied received comprehensive care recommended by urology and cancer groups.

Mark Litwin, UCLA

A study at UCLA?s Jonsson Comprehensive Cancer Center has found that nearly all patients with high-grade, non-invasive bladder cancer are not receiving the guideline-recommended care that would best protect them from a recurrence ? a finding the researchers characterized as alarming.

In fact, out of the 4,545 bladder cancer patients included in the study, only one received the comprehensive care recommended by the American Urology Association 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 Dr. Karim Chamie, a UCLA postdoctoral fellow in urologic oncology and health services research and lead author of the study.

?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,? 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.?

The study appears today (July 11) in the early online edition of the peer-reviewed journal Cancer, a publication of the American Cancer Society.

The study also investigated the cause of such poor compliance. What researchers found was that non-compliance knew no boundaries and that patient-level factors such as age, race, ethnicity or socioeconomic status had very little impact. Instead, non-compliance with guideline-recommended care was primarily attributed to urologists. The patients in the study were elderly but capable of withstanding the simple recommended measures, the researchers said.

?It wasn?t their age, race, ZIP code or how wealthy they were. It all came down to who their doctor was,? Chamie said.

Dr. Mark S. Litwin, a UCLA professor of urology and public health and senior author of the study, said it?s not clear why physicians are not routinely following established guidelines for care.

?It is puzzling, because strong evidence supports those guidelines,? Litwin said. ?But this is a wakeup 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.?

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Source: http://health.universityofcalifornia.edu/2011/07/10/most-bladder-cancer-patients-dont-get-recommended-care/

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