Intravesical - Within the urinary bladder
Bacillus Calmette-Guerin (BCG) - A live attenuated strain of Mycobacterium bovis, first indicated as a tuberculosis vaccine, has had widespread use in intravesical immunotherapy since the 1970's.
Tumor location: urinary bladder
Histology: urothelial carcinoma
Primary Tumor (T) stage:
Ta - Noninvasive and high grade
Tis - Carcinoma in situ: "flat tumor"
T1- tumor invades subepithelial connective tissue (high grade or low grade)
]]>All patients initially diagnosed with T1, Tis or high grade Ta non-muscle invasive bladder cancer with bladder cancer staging within 6 months before to 6 months after the start of the measurement period and a qualified encounter in the measurement period
]]>Intravesical Bacillus-Calmette Guerin (BCG) instillation for initial dose or series:
BCG is initiated within 6 months of the bladder cancer staging
]]>Not Applicable
]]>Equals Initial Population
]]>Immunosuppressed patients, includes HIV and immunocompromised state, with a diagnosis prior to Bladder Cancer Staging
Immunosuppressive drug therapy starting on or before Bladder Cancer Staging
Active Tuberculosis diagnosis during the Bladder Cancer Staging
Mixed histology urothelial cell carcinoma including micropapillary, plasmacytoid, sarcomatoid, adenocarcinoma and squamous disease prior to Bladder Cancer Staging
Patients who undergo cystectomy, chemotherapy or radiation within 6 months of Bladder Cancer Staging
]]>Unavailability of BCG within 6 months after Bladder Cancer Staging
]]>A higher score is the preferred result and indicates better quality
]]>Bladder cancer is ranked 10th for new cancer cases in 2020 and is the 9th leading cause of cancer death in the United States. There are 81,400 estimated new cases in 2020 and 17,980 estimated deaths in 2020. In 2016, there were an estimated 699,450 people living with bladder cancer in the United States. Early detection (discovery of cancer in situ or localized to the primary site) is found in 85% of the patients, and with these there is a five-year survival rate of 95.8% for In Situ and 69.2% for Localized. Bladder cancer is rarely found in patients under age 20, with the median age of diagnosis being 73 (NIH, 2020).
National Comprehensive Cancer Network (NCCN) Guidelines for Bladder Cancer (version 6.2020) defines intravesical BCG as Category 1 Treatment for Ta - high grade, T1 and Tis non-muscle invasive bladder cancer. Most public data reflects prophylactic or adjuvant use of intravesical therapy with the goal of preventing recurrence or delaying progression to a higher grade or stage. BCG has been shown to be effective as prophylaxis to prevent bladder cancer recurrences following TURBT. The NCCN Bladder Cancer Panel Members recommend BCG as the preferred option over Mitomycin C for adjuvant treatment of high-grade lesions (Ta). BCG is also standard therapy for Primary Tis. Most T1 lesions are high risk and are similarly treated with adjuvant intravesical therapy with BCG being a Category 1 recommendation. (NCCN, 2020).
]]>None
]]>None
]]>Intravesical BCG should be administered within 6 months of the initial diagnosis of non-muscle invasive bladder cancer. It may be administered 3-4 weeks after resection, but there needs to be pathological tumor confirmation and must be withheld if there is traumatic catheterization, bacteriuria, persistent gross hematuria, persistent severe local symptoms or systemic symptoms. The normal induction course is 6 weekly instillations of intravesical BCG (AUA Non-Muscle Invasive Bladder Cancer and American Urological Association (AUA) Guideline for the Management of Non-muscle Invasive Bladder Cancer: Stages Ta High Risk, T1 and TIS).
]]>Bacillus Calmette-Guerin (BCG) - A live attenuated strain of Mycobacterium bovis, first indicated as a tuberculosis vaccine, has had widespread use in intravesical immunotherapy since the 1970's.
Tumor location: urinary bladder
Histology: urothelial carcinoma
Primary Tumor (T) stage:
Ta - Noninvasive and high grade
Tis - Carcinoma in situ: "flat tumor"
T1- tumor invades subepithelial connective tissue (high grade or low grade)
]]>BCG is initiated within 6 months of the bladder cancer staging
]]>Immunosuppressive drug therapy starting on or before Bladder Cancer Staging.
Active Tuberculosis diagnosis during the Bladder Cancer Staging.
Mixed histology urothelial cell carcinoma including micropapillary, plasmacytoid, sarcomatoid, adenocarcinoma and squamous disease prior to Bladder Cancer Staging.
Patients who undergo cystectomy, chemotherapy or radiation within 6 months prior to Bladder Cancer Staging.
]]>National Comprehensive Cancer Network (NCCN) Guidelines for Bladder Cancer (version 6.2021) defines intravesical BCG as Category 1 Treatment for Ta - high grade, T1 and Tis non-muscle invasive bladder cancer. Most public data reflects prophylactic or adjuvant use of intravesical therapy with the goal of preventing recurrence or delaying progression to a higher grade or stage. BCG has been shown to be effective as prophylaxis to prevent bladder cancer recurrences following TURBT. The NCCN Bladder Cancer Panel Members recommend BCG as the preferred option over Mitomycin C for adjuvant treatment of high-grade lesions (Ta). BCG is also standard therapy for Primary Tis. Most T1 lesions are high risk and are similarly treated with adjuvant intravesical therapy with BCG being a Category 1 recommendation. (NCCN, 2021).
]]>Bacillus Calmette-Guerin (BCG) - A live attenuated strain of Mycobacterium bovis, first indicated as a tuberculosis vaccine, has had widespread use in intravesical immunotherapy since the 1970's.
Tumor location: urinary bladder
Histology: urothelial carcinoma
Primary Tumor (T) stage:
T1- tumor invades subepithelial connective tissue (high grade or low grade)
Tis - Carcinoma in situ: "flat tumor"
Ta - Noninvasive and high grade
]]>Immunosuppressive drug therapy starting on or before Bladder Cancer Staging.
Active Tuberculosis diagnosis during the Bladder Cancer Staging.
Mixed histology urothelial cell carcinoma including micropapillary, plasmacytoid, sarcomatoid, adenocarcinoma and squamous disease prior to Bladder Cancer Staging.
Patients who undergo cystectomy, chemotherapy or radiation within 6 months prior to Bladder Cancer Staging.
]]>National Comprehensive Cancer Network (NCCN) Guidelines for Bladder Cancer (version 6.2021) defines intravesical BCG as Category 1 Treatment for T1, Tis and Ta - high grade, non-muscle invasive bladder cancer. Most public data reflects prophylactic or adjuvant use of intravesical therapy to prevent recurrence or delay progression to a higher grade or stage. BCG has been shown to be effective as prophylaxis to prevent bladder cancer recurrences following TURBT. The NCCN Bladder Cancer Panel Members recommend BCG as the preferred option over Mitomycin C for adjuvant treatment of high-grade lesions (Ta). BCG is also standard therapy for Primary Tis. Most T1 lesions are high-risk and are similarly treated with adjuvant intravesical therapy, with BCG being a Category 1 recommendation. (NCCN, 2021).
]]>