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Standardized care pathways for patients with suspected urinary bladder cancer: the Swedish experience
Department of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden; Department of Surgery, Urology Section, NU Hospital Group, Trollhättan, Sweden.
Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Department of Clinical and Experimental Medicine, Division of Urology, Linköping University, Linköping, Sweden.
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden.
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2022 (Engelska)Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 56, nr 3, s. 227-232Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVES: To compare time intervals to diagnosis and treatment, tumor characteristics, and management in patients with primary urinary bladder cancer, diagnosed before and after the implementation of a standardized care pathway (SCP) in Sweden.

MATERIALS AND METHODS: Data from the Swedish National Register of Urinary Bladder Cancer was studied before (2011-2015) and after (2016-2019) SCP. Data about time from referral to transurethral resection of bladder tumor (TURBT), patients and tumor characteristics, and management were analyzed. Subgroup analyses were performed for cT1 and cT2-4 tumors.

RESULTS: Out of 26,795 patients, median time to TURBT decreased from 37 to 27 days after the implementation of SCP. While the proportion of cT2-T4 tumors decreased slightly (22-21%, p < 0.001), this change was not stable over time and the proportions cN + and cM1 remained unchanged. In the subgroups with cT1 and cT2-4 tumors, the median time to TURBT decreased and the proportions of patients discussed at a multidisciplinary team conference (MDTC) increased after SCP. In neither of these subgroups was a change in the proportions of cN + and cM1 observed, while treatment according to guidelines increased after SCP in the cT1 group.

CONCLUSION: After the implementation of SCP, time from referral to TURBT decreased and the proportion of patients discussed at MDTC increased, although not at the levels recommended by guidelines. Thus, our findings point to the need for measures to increase adherence to SCP recommendations and to guidelines.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2022. Vol. 56, nr 3, s. 227-232
Nyckelord [en]
Bladder cancer, health services organization, hematuria, management guidelines, multidisciplinary team conferences, population-based, standardized care pathways, time intervals
Nationell ämneskategori
Cancer och onkologi
Identifikatorer
URN: urn:nbn:se:oru:diva-98522DOI: 10.1080/21681805.2022.2058605ISI: 000779277800001PubMedID: 35389306Scopus ID: 2-s2.0-85129124889OAI: oai:DiVA.org:oru-98522DiVA, id: diva2:1651142
Anmärkning

Funding agencies:

Swedish government ALFGBG-873181

Swedish county councils, the ALF-agreement ALFGBG-873181

NU Hospital Group

Tillgänglig från: 2022-04-11 Skapad: 2022-04-11 Senast uppdaterad: 2022-08-04Bibliografiskt granskad

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Jerlström, Tomas
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Institutionen för medicinska vetenskaperRegion Örebro län
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Scandinavian journal of urology
Cancer och onkologi

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