Intravesical bacillus Calmette-Guérin (BCG) instillation: are we doing things right in Latin America?

Introduction and objectives: seventy five percent of bladder cancer is non muscle invasive (NMIBC) for which intravesical instillation with BCG has been the cornerstone of treatment. BCG has been categorized as dangerous; this is why there are international guidelines that describe its use. The objective of this paper is to investigate the adherence of Latin American health workers with guidelines for the safe intravesical application of BCG for NMIBC. Materials and methods: we conducted an anonymous and self-administered survey during 2 months of 2023 on a digital platform among health workers. It consisted of 19 questions focusing on compliance with standards set by international organizations and its correct use. Descriptive statistics were carried out; p<0.05 was considered statistically significant. Correct and safe use of BCG was evaluated through 4 questions. Results: a total of 295 completed surveys were recorded from 12 countries. A total of 96.61 % (n= 285) performed BCG instillation incorrectly. Prior training was received by 55 % of which 97.5 % administered it incorrectly against 95.48 % who did so without prior training (p=0.33). Before answering this questionnaire, 90.51 % considered their technique adequate against 83.83 % after answering it, observing a change in the perception of participants (p= 0.0139). Conclusion: there is almost no adherence of health professionals with protocols, so it is crucial to improve training based on international guidelines to minimize the risk of BCG contamination.