Non-muscle-invasive bladder cancer (NMIBC) requires repeated procedures, long-term surveillance, and sustained access to urologic care. Outcomes are highly sensitive to health disparities. This article examines how social determinants of health including insurance status, socioeconomic factors, gender, ethnicity, geography, and care fragmentation can impact NMIBC care. Delays in hematuria evaluation, underuse and inequitable distribution of intravesical therapy, and decreased surveillance adherence contribute to higher recurrence, progression, and worse quality-of-life outcomes. These disparities may be driven primarily by differences in care delivery rather than tumor biology. Targeted system-level and policy interventions are needed.
The Urologic clinics of North America. 2026 Apr 29 [Epub]
Sha Zhu, Samuel L Washington, Rishi Sekar, Carissa E Chu
Department of Urology, University of California, Mailcode 1695, 550 16th Street, San Francisco, CA 94143, USA., Department of Urology, University of California, Mailcode 1695, 550 16th Street, San Francisco, CA 94143, USA. Electronic address: .