{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T04:28:21Z","timestamp":1793593701411,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bladder cancer is responsible for considerable morbidity and mortality. Patients commonly present with haematuria to primary care for assessment. In Canterbury, New Zealand, the first\u2010line investigations available to primary care were changed in 2018, from urine cytology to CxBladder Triage (CxBT) and upper urinary tract imaging. This retrospective study was performed to evaluate the impact of this change in diagnostics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective audit of routinely collected electronic data from March 2013 to December 2021 from Christchurch Hospital, New Zealand, compared the traditional primary care haematuria pathway with the CxBT haematuria pathway. The primary outcome was waiting time from primary care referral to urological specialist appointment and waiting time to first operative treatment for bladder cancer. Waiting time was further analysed for ethnicity. The secondary outcome was monthly haematuria referrals for urological specialist appointment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 4512 haematuria referrals during the study period. Following the introduction of CxBT to the primary care haematuria pathway, waiting time from primary care referral to urological specialist review reduced by 14.8\u2009days and time to surgery by 15.0\u2009days. There was a greater reduction for M\u0101ori compared with that of non\u2010M\u0101ori patients. The monthly haematuria referrals for urological specialist appointment reduced on average by 6.9 referrals per month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CxBT in primary care haematuria pathway reduces waiting time from primary care referral to urological specialist appointment and to first operative treatment for bladder cancer, whilst also reducing monthly referrals for urological specialist appointments and improving equity for M\u0101ori.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70960","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T01:29:21Z","timestamp":1788830961000},"page":"3046-3051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cxbladder Triage in Haematuria Assessment Reduces Time From Referral to Specialist Assessment and Bladder Cancer Treatment and Improves Equity for M\u0101ori"],"prefix":"10.1111","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2825-3769","authenticated-orcid":false,"given":"Daniel","family":"Eaton","sequence":"first","affiliation":[{"name":"Department of Urology Health NZ Waitaha Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Kerdemelidis","sequence":"additional","affiliation":[{"name":"Population Health, Planning, Funding &amp; Outcomes Health NZ Waitaha Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2939-1650","authenticated-orcid":false,"given":"Giovanni","family":"Losco","sequence":"additional","affiliation":[{"name":"Department of Urology Health NZ Waitaha Canterbury  Christchurch New Zealand"},{"name":"Department of Surgery University of Otago Christchurch  Christchurch New\u00a0Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Mark","sequence":"additional","affiliation":[{"name":"Department of Urology Health NZ Waitaha Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maira","family":"Patu","sequence":"additional","affiliation":[{"name":"Maori Indiginous Health Innovation University of Otago Christchurch  Christchurch New\u00a0Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Elliot","sequence":"additional","affiliation":[{"name":"Department of Radiology Health NZ Waitaha Canterbury  Christchurch New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Frampton","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago Christchurch  Christchurch New\u00a0Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_3_1","unstructured":"National Institute for Health and Care Excellent Guideline \u201cSuspected Cancer: Recognition and Referral \u201d[Updated 12 January 2026; cited 4 April 2026] www.nice.org.uk\/guidance\/ng12."},{"key":"e_1_2_11_4_1","unstructured":"American Urological Association \u201cMicrohematuria: AUA\/SUFU Guideline (2025) \u201d[Updated February 2025; cited 4 April 2026] https:\/\/www.auanet.org\/guidelines\u2010and\u2010quality\/guidelines\/microhematuria."},{"key":"e_1_2_11_5_1","unstructured":"Community HealthPathways \u201cHaematuria in Adults \u201d[Updated 7 August 2023; cited 4 April 2026] https:\/\/canterbury.communityhealthpathways.org\/17392.htm."},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/tcr-20-1990"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bco2.147"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0518-7"},{"key":"e_1_2_11_9_1","first-page":"55","article-title":"Inclusion of a Molecular Marker of Bladder Cancer in a Clinical Pathway for Investigation of Haematuria May Reduce the Need for Cystoscopy","volume":"132","author":"Davidson P. J.","year":"2019","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_11_10_1","first-page":"71","article-title":"Assessment of a Clinical Pathway for Investigation of Haematuria That Reduces the Need for Cystoscopy","volume":"133","author":"Davidson P. J.","year":"2020","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.06.041"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13241"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13873"},{"key":"e_1_2_11_14_1","unstructured":"Stats NZ \u201cPlace and Ethnic GROUP Summaries: Canterbury Region \u201d[Updated 30 June 2025; cited 4 April 2026] https:\/\/tools.summaries.stats.govt.nz\/places\/RC\/canterbury\u2010region#ethnicity."},{"key":"e_1_2_11_15_1","volume-title":"He P\u016brongo Mate Pukupuku o Aotearoa 2020, the State of Cancer in New Zealand 2020","author":"Te Aho o Te Kahu","year":"2021"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.26635\/6965.e1603"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44155-023-00040-6"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0002764213487340"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.26635\/6965.6942"},{"key":"e_1_2_11_20_1","unstructured":"Ministry of Health \u201cAnnual Update of Key Results 2024.25: New Zealand Health Survey \u201d[Updated 19 November 2025; cited 4 April 2026] https:\/\/www.health.govt.nz\/publications\/annual\u2010update\u2010of\u2010key\u2010results\u2010202425\u2010new\u2010zealand\u2010health\u2010survey."},{"key":"e_1_2_11_21_1","unstructured":"Health New Zealand \u201cIdentify Standards: Standards for Consumer and Health Provider Identity Data \u201d[Updated 26 May 2025; cited 4 April 2026] https:\/\/www.tewhatuora.govt.nz\/health\u2010services\u2010and\u2010programmes\/digital\u2010health\/data\u2010and\u2010digital\u2010standards\/approved\u2010standards\/identity\u2010standards."}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70960","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70960","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70960","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T04:24:36Z","timestamp":1793593476000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70960"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/ans.70960"],"URL":"https:\/\/doi.org\/10.1111\/ans.70960","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"assertion":[{"value":"2026-04-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}