{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:01:30Z","timestamp":1785315690355,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T00:00:00Z","timestamp":1782604800000},"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":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to understand clinical pathways for patients with high\u2010risk non\u2010muscle\u2010invasive bladder cancer (HR\u2010NMIBC) from diagnosis to follow\u2010up and to identify opportunities to improve care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional survey was conducted via structured online interviews with consented NHS healthcare professionals (HCPs) from the United Kingdom (UK) between June and September 2025. Topics surveyed included MDT structures\/roles, diagnostic timelines, adjuvant treatment, radical cystectomy (RC) decision making, current bladder\u2010sparing treatment and clinical trial access. Quantitative data were analysed descriptively. Qualitative responses were analysed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy HCPs were included and reported that typically; 88.5% of patients achieve diagnosis within 6\u20138\u2009weeks of referral, and 11.4% reported delays beyond 8\u2009weeks. BCG maintenance duration and completion rates varied. Following BCG induction, a median (IQR) of 20.0% (5.0\u201332.5%) and 60.0% (40.0\u201370.0%) of patients completed \u22652 or \u22641\u00a0years of maintenance, respectively; 1.0% (1.0\u20132.0%) failed to complete induction. For BCG\u2010unresponsive HR\u2010NMIBC, HCPs reported that a mean (\n                      <jats:italic>SD<\/jats:italic>\n                      ) proportion of 53.4 (18.1)% of patients tend to be eligible for and consent to RC, 22.0 (12.6)% tend to be eligible but decline RC and 24.6 (14.9)% tend to be ineligible. Bladder\u2010sparing options remain limited, with 60% of HCPs regarding further BCG as the most appropriate option. All respondents agreed that adherence to quality performance indicators (QPIs) and a national bladder cancer audit would be beneficial. Insufficient specialist nurse capacity to meet foreseeable demands of HR\u2010NMIBC patient care was reported by 70% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200949) of HCPs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results reveal variability in real\u2010world HR\u2010NMIBC care within the NHS. Delays in diagnosis, inconsistent BCG maintenance duration, lack of evidence\u2010based alternatives to BCG and a lack of bladder\u2010sparing treatment and trial options in the BCG\u2010unresponsive setting were identified. Findings highlight unmet needs in relation to MDT resourcing, diagnostic efficiency, trial access, QPI adherence and a national bladder cancer audit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bco2.70236","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:11:29Z","timestamp":1782706289000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["State of the nation: Understanding the current NHS treatment pathway to identify opportunities to advance future care of patients with high\u2010risk non\u2010muscle invasive bladder cancer in the UK (SPAN\u2010UK)"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6189-4720","authenticated-orcid":false,"given":"Jonathan","family":"Aning","sequence":"first","affiliation":[{"name":"Bristol Urological Institute North Bristol NHS Trust  Bristol UK"},{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W. F.","family":"Catto","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, School of Medicine and Population Health University of Sheffield  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6242-1327","authenticated-orcid":false,"given":"Rebecca","family":"Martin","sequence":"additional","affiliation":[{"name":"The Royal Marsden NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Chatterton","sequence":"additional","affiliation":[{"name":"Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paramananthan","family":"Mariappan","sequence":"additional","affiliation":[{"name":"Edinburgh Bladder Cancer Surgery (EBCS), Western General Hospital University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1942-4044","authenticated-orcid":false,"given":"Edward","family":"Ottley","sequence":"additional","affiliation":[{"name":"Real World Evidence OPEN Health Communications LLP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Hickey","sequence":"additional","affiliation":[{"name":"Real World Evidence OPEN Health Communications LLP  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"McCormack","sequence":"additional","affiliation":[{"name":"J&amp;J Innovative Medicine  High Wycombe UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran","family":"Gill","sequence":"additional","affiliation":[{"name":"J&amp;J Innovative Medicine  High Wycombe UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernadett","family":"Szabados","sequence":"additional","affiliation":[{"name":"University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Bladder cancer statistics","year":"2025"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15970"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2005.07.062"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21763"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.12.033"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.010"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67707-5"},{"key":"e_1_2_10_9_1","volume-title":"Bladder cancer: diagnosis and management","author":"National Institute for Health and Care Excellence (NICE)","year":"2015"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)65756-4"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.06.049"},{"key":"e_1_2_10_12_1","volume-title":"BCG\u2010unresponsive nonmuscle invasive bladder cancer: developing drugs and biologics for treatment guidance for industry","author":"U.S. Food and Drug Administration","year":"2018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01665"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2022.05.005"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2019.09.008"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2023.02.044"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15661"},{"key":"e_1_2_10_18_1","unstructured":"Quality of first TURBT for NMIBC.2026. 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