Compared with white-light cystoscopy (WLC), blue-light cystoscopy (BLC) enhances detection of non-muscle-invasive bladder cancer (NMIBC), especially carcinoma in situ (CIS). However, its effects on health care resource utilization and cost burden have not been fully elucidated. This study assessed the economic implications of BLC vs WLC.
We conducted a retrospective cohort analysis with claims data from the Optum Research Database between June 2011 and May 2023. Patients who underwent BLC or WLC were identified, and white-light patients were matched 6:1 to blue-light patients by index year and time between bladder cancer diagnosis and cystoscopy. Inverse probability of treatment weighting was used to adjust for baseline differences. Health care resource utilization and total and bladder cancer-specific costs were calculated on a per-patient-per-month basis.
The final cohort included 794 blue-light and 4764 white-light patients. Before weighting, claims coded for CIS were more frequent in blue-light patients (19.6% vs 8.8%; P < .001). Blue-light patients underwent more upper-tract imaging (71.8% vs 57.8%; P < .001), BCG (24.2% vs 15.8%; P < .001), and biomarker testing (65.0% vs 34.9%; P < .001). After weighting, blue-light patients had a higher mean number of bladder cancer-related ambulatory visits per month (1.3 vs 1.0; P = .004). However, neither all-cause health care resource utilization (3.47 vs 3.21; P = .11) nor total cost ($2987.93 vs $2886.16, per patient per month, P = .65) differed significantly between cohorts.
BLC is associated with greater health care resource utilization for NMIBC without significantly elevating health care costs, suggesting that enhanced diagnostic strategies can be implemented without added financial burden in real-world practice.
JU open plus. 2026 Aug 07*** epublish ***
Mark D Tyson, Mouneeb M Choudry, Chad McKee, Shiv Kalaria, Cerise James, Nicole M Engel-Nitz, Mary G Johnson, Timothy L Barnes
Department of Urology, Mayo Clinic, Phoenix, Arizona., Medical Affairs, Photocure Inc, Princeton, New Jersey., Optum Life Sciences, Eden Prairie, Minnesota.