{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T07:34:28Z","timestamp":1774856068104,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2026,3]]},"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n This work aimed to evaluate the long\u2010term impact of standardized care pathway (SCP) implementation for urinary bladder cancer (UBC) on tumour characteristics, diagnostic and treatment intervals and guideline adherence.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n A retrospective cohort study was conducted including all patients with newly diagnosed UBC at the NU Hospital Group, Sweden, between 2010 and 2024. Patients were grouped into pre\u2010SCP (2010\u20132015) and during\u2010SCP (2016\u20132024) cohorts. Patient demographics, tumour characteristics, adherence to guideline\u2010recommended care and diagnostic and treatment time intervals were analysed. Overall survival was assessed using Kaplan\u2013Meier analysis and Cox proportional hazards regression.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Following SCP implementation, emergency presentations declined significantly (15% pre\u2010SCP to 10% SCP,\n p<\/jats:italic>\n \u2009=\u20090.003). Tumour characteristics shifted towards earlier\u2010stage disease, with increased detection of small tumours \u226430\u2009mm (56% to 71%,\n p<\/jats:italic>\n \u2009<\u20090.001), fewer muscle\u2010invasive cases (27% to 21%,\n p<\/jats:italic>\n \u2009=\u20090.003) and a higher proportion of TaG1\u20132 tumours (42% to 52%,\n p<\/jats:italic>\n \u2009=\u20090.003). Adherence to guidelines improved markedly, reflected in cT1 disease by increased second\u2010look resections (36% to 69%,\n p<\/jats:italic>\n \u2009<\u20090.001) and multidisciplinary team conference discussions (2% to 88%,\n p<\/jats:italic>\n \u2009<\u20090.001). Diagnostic efficiency improved, with median referral\u2010to\u2010TURBT time reduced from 29 to 14\u2009days (\n p<\/jats:italic>\n \u2009<\u20090.001). In multivariable analysis, age, emergency admission, higher tumour stage and size and TURBT delay >18\u2009days were independently associated with worse overall survival. Kaplan\u2013Meier analysis revealed a temporal shift: Early rapid TURBT was associated with poorer survival in 2010\u20132015 but conferred a survival benefit in 2016\u20132024 (log\u2010rank\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200913.66,\n p<\/jats:italic>\n \u2009=\u20090.003).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n SCP implementation was associated with earlier detection, improved guideline adherence and sustained reductions in diagnostic delays. However, increasing delays to definitive treatment for muscle\u2010invasive disease highlight emerging system\u2010level constraints, underscoring the need to optimize downstream capacity to fully realize the benefits of early diagnosis.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/bco2.70179","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:29:27Z","timestamp":1773001767000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Standardized care pathway reshaped the diagnostic and therapeutic landscape of urinary bladder cancer. A 15\u2010year population\u2010based study"],"prefix":"10.1002","volume":"7","author":[{"given":"Mansour","family":"Istamulov","sequence":"first","affiliation":[{"name":"Department of Urology, Institute of Clinical Science, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Urology Section NU\u2010Hospital Group Uddevalla Region V\u00e4stra G\u00f6taland Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-0397","authenticated-orcid":false,"given":"Suleiman","family":"Abuhasanein","sequence":"additional","affiliation":[{"name":"Department of Urology, Institute of Clinical Science, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Surgery, Urology Section NU\u2010Hospital Group Uddevalla Region V\u00e4stra G\u00f6taland 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