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New bladder cancer data are food for thought, but are not conclusive proof that urologists are over-treating early-stage bladder cancer and running up costs.
Their study found that in regions where patients receive costly, high-intensity surveillance and treatment, outcomes seem to be no better than in areas where monitoring and treatment are less intensive (see, "Regional expenditures for early-stage bladder Ca vary," page 1).
These data are important in providing checks and balances to help ensure that urologists are providing appropriate care and not over-utilizing limited health care dollars-an issue that's particularly germane to the national debate over health care reform. However, the study's findings need to be interpreted carefully, and the following points need to be considered:
Badrinath Konety, MD
Dr. Konety is associate professor and vice chair, urology and associate professor, epidemiology & biostatistics, University of California, San Francisco.