Abstract 4028: Establishing optimal care coordination in localized bladder cancer in the United States: A modified Delphi consensus study
Authors: Gautam Jayram, Monika Baskin, Gordon Brown, Mollie Deshazo, Michael Fabrizio, Balaji Hiremalagur, Angela Hunter, Mukul Singhal, Arveen Kaur, Michael Lattanzi, Lynn Redmond, Guru Sonpavde
Journal: Cancer Research (2025)

Abstract Introduction: Care for localized Bladder Cancer (BC) primarily begins with a urologist and generally requires multidisciplinary management. With emerging novel treatments and evolving standards, effective communication and coordination across specialties is crucial. This project aimed to build consensus among clinicians and supporting staff with expertise in managing bladder cancer care, to propose an outline for the optimal management and coordination of care in localized BC originating from the urology clinic. Methods: The project used a modified Delphi method. A steering committee (SC) experienced in BC care coordination (including urologists, medical and radiation oncologists, advanced practitioners and administrators) convened to discuss issues in BC care, developing a series of consensus statements. A finalized set of 46 statements were used in a 4-point Likert scale survey, disseminated by a third-party to healthcare practitioners with active roles managing localized BC in the USA. A consensus threshold was set at 75% agreement. The SC then reconvened to discuss the results and formulate recommendations based the consensus achieved. Results: 300 responses were received across the nation, 102 (34%) from urologists, 79 (26.3%) from medical oncologists, 31 (10.3%) from nurse/nurse navigators, 32 (10.7%) from radiation oncologists, 30 (10%) from advanced practitioner providers, and 26 (8.7%) from administration roles. Of the statements, 38/46 (83%) achieved ≥90% agreement, and 8 (17%) attained ≥75% but &amp;lt;90%. No statements fell below the consensus threshold. Sub-analyses showed there was disagreement between urologists in different practice settings, although there was overall concordance in agreement levels between responder roles. 95% agreed multidisciplinary teams and tumor boards need to be created to facilitate bladder cancer care. 97% agreed clear and ongoing provider to provider communication during care is essential to maximize outcomes. 98% agreed patients need to be educated on all treatment options to facilitate informed decision making. From the statements with highest agreement, a series of 10 recommendations were developed. Conclusions: These consensus recommendations from 300 experienced healthcare practitioners and allied healthcare professionals from all major localized BC treating specialties provide a roadmap toward improving the quality of care of these patients. Citation Format: Gautam Jayram, Monika Baskin, Gordon Brown, Mollie Deshazo, Michael Fabrizio, Balaji Hiremalagur, Angela Hunter, Mukul Singhal, Arveen Kaur, Michael Lattanzi, Lynn Redmond, Guru Sonpavde. Establishing optimal care coordination in localized bladder cancer in the United States: A modified Delphi consensus study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4028.