Challenges in the Pathology of Non–Muscle-invasive Bladder Cancer: A Dialogue Between the Urologic Surgeon and the Pathologist

Approximately 70%-80% of urothelial carcinomas are detected at the stage of non–muscle-invasive bladder cancer (NMIBC). Initial management is often successful, but recurrence is common and leads to a long, burdensome, costly disease course. The quality and efficiency of care depends in part on accurate, clearly communicated descriptions of tumor characteristics. This review identifies current best practices, unmet needs, and key issues in the pathology of NMIBC for the practicing urologist. Reasonable and objective recommendations are provided with the goal of improving urologist-pathologist communication, the efficiency of healthcare utilization, and outcomes for patients with NMIBC.