Use of Shared Decision-Making in Non-Muscle-Invasive Bladder Cancer: Protocol for a Scoping Review

With a growing range of treatment options for non-muscle-invasive bladder cancer (NMIBC), the emergence of longitudinal patient-reported quality-of-life data, and an aging population managing the treatment burden of coexisting conditions, there is an increasing need for shared decision-making processes and tools to support urologists and patients in navigating complex treatment decisions. What remains unknown is how shared decision-making is currently incorporated into NMIBC treatment decisions and which factors inform key decisions in NMIBC.

The objective of this scoping review is to map and characterize the existing literature on shared decision-making in NMIBC, with a focus on decision-making tools, decision points in the NMIBC cancer journey, and factors influencing patient and clinician decision-making.

This scoping review protocol was designed in accordance with the Joanna Briggs Institute scoping review methodology. The final results will be reported in a subsequent publication in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) 2018 guidelines. A comprehensive search strategy will identify published, unpublished, and gray literature from databases (PubMed, Embase, CINAHL, PsycInfo, and Web of Science), professional society websites, and foundation websites. Eligibility criteria were determined based on the population, concept, and context framework. The population will include adults aged ≥18 years at the time of NMIBC diagnosis, with urothelial histology. The concept focuses on existing shared decision-making tools and patient- and urologist-level factors contributing to decisions. The context includes urology clinics in academic and community settings.

The literature search was conducted in September 2025. Title and abstract screening, full-text review, qualitative data coding, and quantitative data analysis are anticipated to be completed by October 2026.

The treatment landscape for NMIBC is rapidly evolving, with a growing range of options, each with its own risks and benefits. This scoping review will help elucidate how shared decision-making is currently used in NMIBC treatment decisions and identify the key factors that are important to both urologists and patients. These data will guide future intervention development and research to enhance the quality of shared decision-making in NMIBC.