Investigating gender disparities in urological care for non-muscle invasive bladder cancer (NMIBC)

Abstract

Objective

This study aims to explore possible gender disparities in urological diagnostic and therapeutic care for NMIBC, particularly in the use of enhanced endoscopic imaging techniques.

Materials and Methods

An international survey in seven languages was distributed to all members of the Société Internationale d'Urologie (SIU). We captured specifications related to TURBT performance, attitudes towards the use of enhanced imaging and adherence to international guidelines for non-muscle invasive bladder cancer. Data were analysed using descriptive statistics. Gender disparities were assessed using propensity score matching (PSM) for age, working environment, subspecialisation and years of experience.

Results

A total of 3595 SIU members from 91 countries participated (response rate 35%). Male participants performed a higher volume of TURBTs per month (p = 0.0087). In accordance with guidelines, taking biopsies from normal or abnormal appearing tissue was rated equally among males and females (p = 0.68 for each). No significant gender-based differences were observed in attitudes towards the benefits of enhanced imaging techniques, including PPD, NBI and Image 1S. This was consistent for identification of satellite lesions (p = 0.99) and completeness of TURBT, including resection of margins (p = 0.07) and tumour floor (p = 0.66). Guidelines were followed equally by both sexes, with a strong preference for EAU guidelines. Similar findings were observed among residents and fellows.

Conclusion

No significant gender-related disparities were found in urological care for NMIBC, including the use of enhanced imaging techniques. These findings apply to both urologists and trainees, with comparable adherence to guidelines.