Bladder cancer patients in the UK are enduring unacceptably long waiting times for diagnosis and treatment. The situation has remained stagnant over the past decade, prompting calls from leading experts for a national bladder cancer audit. This initiative is seen as essential to improve care standards and outcomes across the country.
Krishna Narahi, Chair of the BAUS Oncology Section, recently emphasised the critical need for such an audit: “10 years on, bladder cancer care in the UK has not improved. A national QI initiative is needed to shift focus from reporting to improving care. A national bladder cancer audit will do just that.” Narahi’s comments, made during the BAUS24 conference, highlight the frustration and urgency felt within the medical community.
The symposium, hosted by medac GmbH, featured a compelling presentation by Professor Jim Catto of The University of Sheffield. He discussed how a national bladder cancer audit could replicate the success seen in audits for prostate and lung cancers. These audits have proven effective in standardising care, reducing regional disparities, and ultimately improving patient outcomes. For bladder cancer, a similar approach could be transformative.
The Current State of Bladder Cancer Care
Bladder cancer care in the UK is marked by significant regional variation and overall decline in survival rates. Since 2012, five-year survival rates for bladder cancer have decreased: from 43% to 41% for women, and from 58% to 56% for men. These statistics highlight a worrying trend that clearly demonstrates the need for immediate action.
One of the primary issues is the variability in the quality of treatment across different hospitals. Currently, only 12% of hospitals have a Transurethral Resection of Bladder Tumour (TURBT) audit program. This lack of consistent auditing means that best practices are not uniformly applied, leading to disparate outcomes for patients based on their geographical location.
Furthermore, despite a target that all patients should receive a diagnosis within one month of referral, the reality is far from this goal. Half of all patients wait 1.4 months or longer for TURBT, and a quarter wait 2.4 months or longer. These delays can have serious implications for the progression of the disease and the overall prognosis for patients.
The Case for a National Bladder Cancer Audit
A national bladder cancer audit would systematically collect data on care pathways and treatment outcomes. This data is crucial for identifying and addressing regional disparities in care. By understanding where and why variations occur, healthcare providers can implement best-practice approaches more consistently.
Such an audit would also facilitate a more evidence-based approach to treatment. By analysing the outcomes of different treatment modalities, healthcare providers can refine and optimise their protocols. This is particularly important for a disease like bladder cancer, where timely and effective treatment is crucial for improving survival rates.
The success of national audits for prostate and lung cancers serves as a powerful precedent. These audits have not only improved the quality of care but have also increased survival rates for these cancers. Applying a similar model to bladder cancer could yield significant benefits.
Moving from Reporting to Improvement
A key aspect of the proposed national bladder cancer audit is its focus on quality improvement (QI). While reporting is important for understanding the current state of care, it is the action taken in response to this data that will drive real change. A QI initiative would ensure that the insights gained from the audit are translated into tangible improvements in care delivery.
This shift from reporting to improvement is essential for reversing the decline in bladder cancer survival rates. By fostering a culture of continuous improvement, the audit could help to elevate the standard of care across the UK.
The need for a national bladder cancer audit in the UK is clear
With survival rates declining and significant regional variations in care, it is vital to adopt a systematic approach to understanding and improving bladder cancer treatment. As highlighted by experts at the BAUS24 conference, such an audit would provide the data needed to implement best practices consistently, ultimately improving outcomes for patients.
Immediate action is required to address the long waiting times and variability in treatment quality. A national bladder cancer audit represents a vital step towards ensuring that all patients receive the timely and effective care they deserve. The time to act is now, to prevent further declines in survival rates and to provide hope for those affected by this devastating disease.
