title: The burden of bladder cancer care: direct and indirect costs.
abstract: OBJECTIVE
  Bladder cancer is a common, complex, and costly disease. Every year in the USA, bladder cancer is responsible for 70 ,000 diagnosed cases and over 15, 000 deaths. Once diagnosed, patients with nonmuscle invasive bladder cancer (NMIBC) are committed to a lifetime of invasive procedures and potential hospitalizations that result in substantial direct and indirect costs.
  
  
  RESULTS
  Bladder cancer is the most costly cancer among the elderly, estimated at nearly $4 billion per year, and has the highest cost of any cancer when categorized on a per patient basis. The direct economic cost of NMIBC is fueled by the need for lifelong cystoscopic examination and variations in treatment algorithms. This fiscal burden is further compounded by the indirect impact on psychological health and quality of life of patients and their families. Despite the development of new technologies, such as novel urinary biomarkers and innovative cystoscopic methods, no alternative to cystoscopic surveillance has been established.
  
  
  CONCLUSIONS
  The management of patients with NMIBC is responsible for a substantial financial burden with indirect costs that extend beyond quantifiable direct costs.
authors.affiliation: University of Washington School of Medicine of Washington School of Medicine, Department of Urology, Seattle, Washington, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Mossanen
authors.forename: John L
authors.initials: JL
authors.lastname: Gore
mesh_terms: D017281:Cost of Illness; D003558:Cystoscopy / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D011787:Quality of Health Care / Q000191:economics; D011788:Quality of Life / Q000523:psychology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000191:economics* / Q000523:psychology / Q000628:therapy*