Contemporary Role for Blue Light Cystoscopy Across the Bladder Cancer Disease Spectrum

PURPOSE OF REVIEW: This review aims to synthesize recent evidence and accounts evaluating the utility of blue light cystoscopy (BLC) across the disease spectrum of bladder cancer, including its diagnostic, surveillance, and post-treatment uses, as well as its outpatient applications, economic impact, patient perspectives, and future directions. RECENT FINDINGS: While initial studies on BLC suggested an advantage over traditional cystoscopy in terms of diagnostic power and recurrence rates for non-muscle invasive bladder cancer, recent studies are more equivocal on its benefits and suggest that the utilization of blue-light cystoscopy is more nuanced. Evidence is lacking on a clear superiority of blue light for all bladder cancer patients. Cost, logistics, and accuracy concerns indicate certain patients may benefit from this procedure more than others. BLC can be a valuable adjunct to white light cystoscopy in the management of bladder cancer. It provides high diagnostic sensitivity but there are questions surrounding its cost-effectiveness, positive predictive value, and its role in effective surveillance and reduction of tumor recurrence require further longitudinal and standardized investigation.