Introduction:Medicare eligibility at 65 has been associated with increased diagnosis and survival for certain cancers due to greater health care utilization. We aim to assess for a similar ...

Non-muscle-invasive bladder cancer (NMIBC) comprises approximately 75% of new bladder cancer cases and generally carries a favorable prognosis, yet high rates of recurrence and progression necessitate close surveillance with frequent cystoscopies and repeated transurethral resections. Upfront treatment for high-risk disease is typically Bacillus Calmette-Guérin (BCG), although combinations with immune checkpoint inhibitors have reported results. Patients with BCG-unresponsive, intolerant, or refractory disease represent a subset of patients with high risk of progression, with early radical cystectomy being the standard approach for this setting. Global BCG shortages and the substantial impact of cystectomy on quality of life underscore the need for therapeutic alternatives. Over the past decade, investigational trials in immunotherapy have expanded treatment options for BCG-unresponsive NMIBC with CIS, leading to FDA approval of intravesical nadofaragene firadenovec, nogapendekin alfa-inbakicept, and systemic pembrolizumab. This narrative review summarizes developments in intravesical and systemic immunotherapies for NMIBC, highlights ongoing trials, and addresses controversies in trial design, treatment sequencing, comparative efficacy, and safety.

To examine the effects of author gender and race on citation metrics, including Altmetric Attention Scores (AAS), in urology publications. We analyzed 91,100 urology publications published between 2009 and 2023, retrieved from the Altmetric database via Drexel University. Author gender was identified using GenderGuesser, and race was estimated using a published name-based algorithm. Publications were grouped by the gender of the first and last authors (e.g., MF: male first, female last). We compared AAS and calculated the Mean Citation Difference (MCD) to measure citation disparities against gender- and race-neutral models. Publications with male first and last authors (MM) comprised 44%, while female-female (FF) authorship accounted for only 6% of all publications. FF-authored studies were the most under-cited (MCD: -1.9), whereas FM-authored studies were the most over-cited (+2.53). Although female-authored papers had higher AAS scores, they remained under-cited across most urologic subspecialties. Racial disparities in citation metrics were less pronounced than those related to gender, and AAS differences between racial groups were not statistically significant. Publications authored by female first and last authors continue to be under-cited despite receiving higher AAS scores, and funding. In contrast, racial citation disparities appear to be minimal. These findings highlight the need to address gender-based inequities in academic recognition, as doing so may foster a more inclusive academic environment and ultimately improve access to equitable patient care. This study examined how often urology research papers are cited based on the gender and race of the authors. We found that studies led by women are cited less frequently than those led by men, despite receiving more online attention and funding. These findings underscore the need for fairer recognition of all researchers, as greater equity in academic publishing may help promote more inclusive and accessible patient care.