Hematuria to Bladder Cancer Management Timeliness: A Baseline Study at a Veterans Affairs Facility

• Bladder cancer is found primarily in men, smokers, and the elderly.
• Hematuria is the presenting symptom in ∼80% of bladder cancers although most hematuria is benign.
• New guidelines recommend evaluation for a single unexplained finding of hematuria.
• The study population was slower than expected in the identification and management of bladder cancer.
• Providers should critically evaluate urinalyses among those at risk and refer hematuria expediently.

Bladder cancer is usually identified through the investigation of unexplained hematuria. Bladder cancer has importance to American veteran health care because of a recognized link to tobacco abuse. A retrospective medical record review conducted at a Veterans Affairs Medical Center determined the current time frames that local veterans wait between first noted hematuria and management of bladder cancer, with the goal of improving timeliness of diagnosis and management of new cancers. This study identifies several systems changes and educational opportunities to improve timeliness from the identification of hematuria through the management of new urothelial malignancies.