Cxbladder Triage in Haematuria Assessment Reduces Time From Referral to Specialist Assessment and Bladder Cancer Treatment and Improves Equity for Māori
6 affiliations
- 1Department of Urology Health NZ Waitaha Canterbury Christchurch New Zealand
- 2Population Health, Planning, Funding & Outcomes Health NZ Waitaha Canterbury Christchurch New Zealand
- 3Department of Surgery University of Otago Christchurch Christchurch New Zealand
- 4Maori Indiginous Health Innovation University of Otago Christchurch Christchurch New Zealand
- 5Department of Radiology Health NZ Waitaha Canterbury Christchurch New Zealand
- 6Department of Medicine University of Otago Christchurch Christchurch New Zealand
Abstract
Background: Bladder cancer is responsible for considerable morbidity and mortality. Patients commonly present with haematuria to primary care for assessment. In Canterbury, New Zealand, the first‐line investigations available to primary care were changed in 2018, from urine cytology to CxBladder Triage (CxBT) and upper urinary tract imaging. This retrospective study was performed to evaluate the impact of this change in diagnostics.
Methods: A retrospective audit of routinely collected electronic data from March 2013 to December 2021 from Christchurch Hospital, New Zealand, compared the traditional primary care haematuria pathway with the CxBT haematuria pathway. The primary outcome was waiting time from primary care referral to urological specialist appointment and waiting time to first operative treatment for bladder cancer. Waiting time was further analysed for ethnicity. The secondary outcome was monthly haematuria referrals for urological specialist appointment.
Results: There were 4512 haematuria referrals during the study period. Following the introduction of CxBT to the primary care haematuria pathway, waiting time from primary care referral to urological specialist review reduced by 14.8 days and time to surgery by 15.0 days. There was a greater reduction for Māori compared with that of non‐Māori patients. The monthly haematuria referrals for urological specialist appointment reduced on average by 6.9 referrals per month.
Conclusion: CxBT in primary care haematuria pathway reduces waiting time from primary care referral to urological specialist appointment and to first operative treatment for bladder cancer, whilst also reducing monthly referrals for urological specialist appointments and improving equity for Māori.
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BibTeX
@article{eaton2026cxbladder,
title = {{Cxbladder Triage in Haematuria Assessment Reduces Time From Referral to Specialist Assessment and Bladder Cancer Treatment and Improves Equity for Māori}},
author = {Daniel Eaton and Melissa Kerdemelidis and Giovanni Losco and Stephen Mark and Maira Patu and Nikki Elliot and Chris Frampton},
journal = {Anz Journal of Surgery},
year = {2026},
month = sep,
doi = {10.1111/ans.70960},
url = {https://doi.org/10.1111/ans.70960},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Cxbladder Triage in Haematuria Assessment Reduces Time From Referral to Specialist Assessment and Bladder Cancer Treatment and Improves Equity for Māori
AU - Daniel Eaton
AU - Melissa Kerdemelidis
AU - Giovanni Losco
AU - Stephen Mark
AU - Maira Patu
AU - Nikki Elliot
AU - Chris Frampton
PY - 2026
DA - 2026/09/07
JO - Anz Journal of Surgery
DO - 10.1111/ans.70960
UR - https://doi.org/10.1111/ans.70960
AB - Background: Bladder cancer is responsible for considerable morbidity and mortality. Patients commonly present with haematuria to primary care for assessment. In Canterbury, New Zealand, the first‐line investigations available to primary care were changed in 2018, from urine cytology to CxBladder Triage (CxBT) and upper urinary tract imaging. This retrospective study was performed to evaluate the impact of this change in diagnostics. Methods: A retrospective audit of routinely collected electronic data from March 2013 to December 2021 from Christchurch Hospital, New Zealand, compared the traditional primary care haematuria pathway with the CxBT haematuria pathway. The primary outcome was waiting time from primary care referral to urological specialist appointment and waiting time to first operative treatment for bladder cancer. Waiting time was further analysed for ethnicity. The secondary outcome was monthly haematuria referrals for urological specialist appointment. Results: There were 4512 haematuria referrals during the study period. Following the introduction of CxBT to the primary care haematuria pathway, waiting time from primary care referral to urological specialist review reduced by 14.8 days and time to surgery by 15.0 days. There was a greater reduction for Māori compared with that of non‐Māori patients. The monthly haematuria referrals for urological specialist appointment reduced on average by 6.9 referrals per month. Conclusion: CxBT in primary care haematuria pathway reduces waiting time from primary care referral to urological specialist appointment and to first operative treatment for bladder cancer, whilst also reducing monthly referrals for urological specialist appointments and improving equity for Māori.
SN - 1445-1433
SN - 1445-2197
ER -