title: Can efficiency of follow-up for superficial bladder cancer be increased?
abstract: This study evaluated the efficiency with which follow-up cystoscopy was employed in a population-based cohort of patients with superficial bladder cancer. Subjects were 240 men, aged under 75 years, with superficial bladder cancer first diagnosed in 1982. The median duration of follow-up was 6.1 years. The median (interquartile range) number of follow-up cystoscopies was 8 (5-12) per patient with a patient-specific annual rate of 1.7 (1.2-2.2) per year. The median number of cystoscopies at which recurrent tumour was detected was 2 (0-5) per patient, patient-specific annual rate 0.4 (0.0-1.3) per year of follow-up. Among patients with a single tumour at diagnosis and a negative first check cystoscopy (MRC group 1), the proportion of positive cystoscopies was 0.1 (0.0-0.4). Comparison of observed intervals between cystoscopies with optimal intervals calculated using an optimisation model showed that patients in MRC group 1 were seen sooner in practice than the model predicted, while in practice other patients were seen later than the model predicted. These data support the suggestion that efficiency of follow-up for patients with superficial bladder cancer could be increased by dividing patients into groups with different risks of recurrence and differing follow-up requirements.
authors.affiliation: Department of Public Health Medicine, United Medical School, Guy's Hospital, London.
authors.forename: M C
authors.initials: MC
authors.lastname: Gulliford
authors.forename: A
authors.initials: A
authors.lastname: Petruckevitch
authors.forename: P G
authors.initials: PG
authors.lastname: Burney
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003558:Cystoscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*