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Standardized care pathways for patients with suspected urinary bladder cancer : the Swedish experience

Abuhasanein, Suleiman ; Jahnson, Staffan ; Aljabery, Firas ; Gårdmark, Truls ; Jerlström, Tomas ; Liedberg, Fredrik LU ; Sherif, Amir ; Ströck, Viveka and Kjölhede, Henrik LU (2022) In Scandinavian Journal of Urology 56(3). p.227-232
Abstract

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... (More)

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.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bladder cancer, health services organization, hematuria, management guidelines, multidisciplinary team conferences, population-based, standardized care pathways, time intervals
in
Scandinavian Journal of Urology
volume
56
issue
3
pages
6 pages
publisher
Taylor & Francis
external identifiers
  • scopus:85129124889
  • pmid:35389306
ISSN
2168-1805
DOI
10.1080/21681805.2022.2058605
language
English
LU publication?
yes
id
813ce389-1527-4b08-bd8d-3ed4f92c37d9
date added to LUP
2022-08-15 12:36:03
date last changed
2025-04-19 00:09:28
@article{813ce389-1527-4b08-bd8d-3ed4f92c37d9,
  abstract     = {{<p>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 &lt; 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.</p>}},
  author       = {{Abuhasanein, Suleiman and Jahnson, Staffan and Aljabery, Firas and Gårdmark, Truls and Jerlström, Tomas and Liedberg, Fredrik and Sherif, Amir and Ströck, Viveka and Kjölhede, Henrik}},
  issn         = {{2168-1805}},
  keywords     = {{Bladder cancer; health services organization; hematuria; management guidelines; multidisciplinary team conferences; population-based; standardized care pathways; time intervals}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{227--232}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Standardized care pathways for patients with suspected urinary bladder cancer : the Swedish experience}},
  url          = {{http://dx.doi.org/10.1080/21681805.2022.2058605}},
  doi          = {{10.1080/21681805.2022.2058605}},
  volume       = {{56}},
  year         = {{2022}},
}