Lower proportion of bladder cancer diagnosed at unscheduled hospitalization after introduction of standardized care pathways in Sweden

OBJECTIVE: To investigate the probability for being diagnosed with bladder cancer in conjunction with unscheduled hospitalization before and after 2015 when standardized care pathways (SCP) for urinary tract cancer was introduced in Sweden. MATERIAL AND METHODS: Unscheduled hospitalization was defined as in-hospital care with transurethral resection of bladder tumor without previous outpatient cystoscopy in patients with bladder cancer in BladderBaSe 2.0. Three calendar years before introduction of SCP (2011-2014) and after (2016-2019) were compared using adjusted logistic regression models to calculate the odds ratio (OR) for being diagnosed at an unscheduled hospital admission. RESULTS: The study included 9998 and 11,647 patients diagnosed before and after the introduction of SCP, respectively. Proportions of patients diagnosed with bladder cancer in conjunction with unscheduled hospitalization was 13% before and 7% after implementation of SCP. Compared to patients diagnosed prior to introduction of SCP, patients diagnosed after had an adjusted OR for unscheduled hospitalization of 0.50 (95% confidence interval 0.46-0.55). CONCLUSIONS: Following the implementing SCP for bladder cancer, the proportion of patients diagnosed with bladder cancer during an unscheduled hospitalization in Sweden decreased, even after adjustment for potential confounders.