Diagnosis of Non-Muscle Invasive Bladder Cancer

ContextEarly detection and diagnosis improves both the management and survival of patients with non-muscle invasive bladder cancer (NMIBC).ObjectiveTo provide a review of current approaches to the diagnosis of NMIBC as well as practical recommendations.Evidence acquisitionA committee of internationally renowned leaders in bladder cancer management, known as the International Bladder Cancer Group (IBCG), was convened in October 2006 to review current literature surrounding the diagnosis of NMIBC as well as the current clinical practice guidelines of the European Association of Urology (EAU), the First International Consultation of Bladder Tumours (FICBT), the National Comprehensive Cancer Network (NCCN), and the American Urological Association (AUA). Following the inaugural meeting in October 2006, the IBCG met on three subsequent occasions to exchange ideas and develop uniform and practical recommendations for the diagnosis of NMIBC.Evidence synthesisThe IBCG provided practical recommendations for the assessment and diagnosis of NMIBC.ConclusionsThe diagnosis of NMIBC is ultimately made by transurethral resection of the bladder tumour (TURBT). Cystoscopy should be performed in all patients, and the aspect, number, shape, size, and location of the tumour should be documented. Ultrasonography and/or intravenous urography/computed tomography–urogram should only be used in select patients with multiple or trigonal tumours. A repeat TURBT is recommended in high-grade T1 tumours or if the initial resection was incomplete and/or when there is no muscle in the specimen.