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Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline (2026)
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Access FAQs on AUA clinical guideline usage and licensing.
By reading this guideline, you agree to AUA's Guidelines Terms and Conditions of Use.
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Access to AUA guidelines is provided free for individual clinical use only, in accordance with the AUA Guidelines Terms and Conditions of Use. Anyone accessing AUA guidelines for any other purpose must obtain a license/permission in advance. Licenses for academic, research and educational purposes (e.g., in course packs or employer-sponsored research) can be requested through the AUA by contacting permissions@AUAnet.org.
Licenses for promotional or commercial use can be requested by contacting Keith Price at kprice@AUAnet.org.
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Amendment Summary for this Guideline
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The Journal of Urology® Articles
Unabridged PDF for this Guideline
(Published 2016; Amended 2020, 2024, 2026)
Purpose
The survival rate for the majority of patients with non-muscle invasive bladder cancer (NMIBC) is favorable; however, the rates of recurrence and progression to muscle-invasive bladder cancer (MIBC) are important surrogate endpoints for overall prognosis, as these are major determinants of long-term outcome. The recurrence and progression probability rates depend on several clinical and pathologic factors. Therefore, the ability to predict risk of recurrence and progression and treating the disease appropriately is important. This Guideline provides a risk-stratified clinical framework for the management of NMIBC. Please also refer to the associated NMIBC Treatment Algorithm.
Key Takeaways
NMIBC is a clinically heterogeneous group of cancers with a wide range of recurrence and progression probabilities that depend on several clinical and pathologic factors. As such, the ability to predict recurrence and progression risk in NMIBC based on patient-specific disease characteristics holds prognostic significance. Risk stratification in NMIBC aids personalized treatment decisions and surveillance strategies as opposed to a generalized “one-size fits all” approach. To this end, this Guideline provides a useful reference for an evidence-based approach to management of NMIBC with discussion of the following:
- Diagnosis, risk stratification, and histology
- Use of urine markers
- Timing, technique, goal, and indication for TURBT/repeat resection
- Use of intravesical therapy; BCG/maintenance; chemotherapy/BCG combinations
- BCG relapse and salvage regimens
- The role of cystectomy
- Enhanced cystoscopy
- Risk-adjusted surveillance and follow-up strategies
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