The worldwide adoption of enhanced endoscopic imaging in diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC): snapshot analysis from a global survey.

PURPOSE: To describe the availability and use of enhanced endoscopic imaging technology as well as the factors that impact endoscopic imaging method preferences in the treatment of NMIBC.

METHODS

A cross-sectional online survey was prepared to capture real-life practices globally, in the endoscopic assessment and treatment of NMIBC. The survey was distributed by the Société Internationale d'Urologie (SIU) to all its members and made available in 7 languages. The data was reported quantitatively, measuring variability and central tendency.

RESULTS

From the 3595 respondents (across 91 countries) 39.1% were in practice for > 20 years and 56,5% were general urologists, followed by 16.8% uro-oncologist and 8.4% endourologist. White light (WL) was the most often available endoscopic technology. Of the respondents, 60% perform < 5 TURBT/month and only 15% perform > 10 TURBT/month. 64% of the respondents had only access to WL endoscopy whereas 29% of the respondents had access to NBI, 11% to PDD and 6% to IMAGE 1S. The majority agreed on their benefit in tumor resection, detection of satellite lesions and decrease recurrence rate in pT1 tumors. Lastly, half of the respondents reported not having followed any training on the use of enhanced techniques.

CONCLUSION

Overall, there is the belief that the use of enhanced imaging techniques allows for a more complete TURBT and to prevent recurrences. Notably most respondents performed less than 5 TURBTs/month, and the highest volume is performed by general urologists. Respondents predominantly have access to WL endoscopy only, mostly due to income, work setting, and lack of training.