Badrinath R. Konety, MD, is the assistant professor, department of urology, University of Iowa, and chief of the urology service, VA Medical Center, Iowa City.
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.