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GP experts launch bladder cancer campaign amid criticisms of NICE guidance

GP experts in urology have launched a new campaign urging GPs to follow up people with blood in pee, after warning that changes to bladder cancer referral guidelines proposed by NICE are likely to make it harder for GPs to refer patients.

Launching a major new awareness campaign alongside three bladder cancer charities, GPSI in urology Dr Jonathan Rees said GPs needed to be encouraged to investigate people with haematuria more thoroughly, particularly if they have other symptoms such as dysuria or are at high risk because of their age or smoking – but that proposed NICE recommendations would deter them from doing so.

The ‘Shout out about bladder cancer’ campaign run by Action on Bladder Cancer, Fight Bladder Cancer and The Urology Foundation, warns that bladder cancer is the seventh most common cancer in the UK, but the only ‘top ten’ cancer where prognosis is worsening.

Dr Rees said GPs had become ‘desensitised’ about bladder cancer and that NICE should drop proposals to restrict the referral of people with haematuria according to their age, and also include more helpful recommendations about ‘risk stratifying’ patients, to help people get investigated more promptly.

It comes after NICE put forward plans to restrict referral for visible and non-visible haematuria in younger patients.

Dr Rees told Pulse: ‘We have become a little desensitised to bladder cancer because of the overlap with other conditions – we forget that a lot of people who present with bladder cancer present with symptoms similar to urinary tract infections, so it’s very easy to get lost down the infection track.’

He added: ‘We have concerns about NICE over the age restrictions, but also the fact they don’t mention these other factors, such as dysuria, or storage symptoms with haematuria.

‘The problem is it is not encouraging risk stratification. They don’t really address what you do with someone who is high risk – such as a smoker. If someone is a heavy smoker then the age range is completely inappropriate, because you’ve got to investigate them.

‘Our objections have been raised with NICE so we are waiting to see how they respond.’

Readers' comments (2)

  • As the mother of a 28 year old daughter, and a specialist Nurse in Palliative care, I would like to express my concerns that haematuria should be investigated as a matter of urgency.
    My daughter was diagnosed with high grade invasive bladder cancer at 27 years of age, following months of being treated for a UTI.
    A GP she had not consulted previously had the sense to refer her to a urologist, where the diagnosis was made.
    After 12 months of chemo; surgery and radiotherapy, my daughter died.
    Bladder cancer is not just an older person's disease, and should not be dismissed on account of a person's age.

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  • A sad, but very true reminder to all of us medicos to be vigilant and thorough. We must always put our patients first... Always follow up! ...Thank-you for sharing this poignant story with your colleagues.

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