In regards to a National Bladder Cancer Audit consideration, I refer the Hon. Member to the answer given to the Hon. Member for Epsom and Ewell on 10 December 2025 to Question 96365.

The Department does not hold data on cancer incidence for the United Kingdom. The latest data on bladder cancer incidence available, in England, can be found at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/cancer-registration-statistics/england-2023

Improving cancer outcomes, including for bladder cancer, is a priority for the Government. The forthcoming National Cancer Plan will set out further actions to improve earlier diagnosis, expand access to the latest treatments and technologies, and improve survival rates across England.

National cancer registry data shows a small but sustained decline in bladder cancer survival rates over recent years. One-year survival fell from approximately 72% to 69.6%, and five-year survival from 51.5% to 47.2% between 2007 to 2011 and 2016 to 2020.

To improve treatment times, we have invested £70 million of funding into new radiotherapy treatment machines to replace older, less efficient machines. These new machines are currently being rolled out to trusts throughout the country. These newer machines will reduce treatment times, boost productivity, and allow more patients to be seen over the same period.

In addition, non-specific symptom pathways have been introduced to speed up diagnosis for patients whose symptoms may indicate cancer but which do not align clearly with a specific tumour type. This helps ensure that more patients are referred, investigated, and diagnosed earlier, including cases of bladder cancer that present with broader or less specific symptoms.

The NHS Cancer Programme has commissioned 10 national clinical audits covering breast, ovarian, pancreatic, lung, prostate, oesophago-gastric, bowel, non-Hodgkin lymphoma, and kidney cancers. These were selected as auditing was expected to have the greatest impact on reducing unwarranted variation in care. For this reason, there are currently no plans to undertake a national clinical audit for bladder cancer, though bladder cancer outcomes continue to be monitored through existing national cancer datasets.

Improving cancer outcomes, including for bladder cancer, is a priority for the Government. The forthcoming National Cancer Plan will set out further actions to improve earlier diagnosis, expand access to the latest treatments and technologies, and improve survival rates across England.

National cancer registry data shows a small but sustained decline in bladder cancer survival rates over recent years. One-year survival fell from approximately 72% to 69.6%, and five-year survival from 51.5% to 47.2% between 2007 to 2011 and 2016 to 2020.

To improve treatment times, we have invested £70 million of funding into new radiotherapy treatment machines to replace older, less efficient machines. These new machines are currently being rolled out to trusts throughout the country. These newer machines will reduce treatment times, boost productivity, and allow more patients to be seen over the same period.

In addition, non-specific symptom pathways have been introduced to speed up diagnosis for patients whose symptoms may indicate cancer but which do not align clearly with a specific tumour type. This helps ensure that more patients are referred, investigated, and diagnosed earlier, including cases of bladder cancer that present with broader or less specific symptoms.

The NHS Cancer Programme has commissioned 10 national clinical audits covering breast, ovarian, pancreatic, lung, prostate, oesophago-gastric, bowel, non-Hodgkin lymphoma, and kidney cancers. These were selected as auditing was expected to have the greatest impact on reducing unwarranted variation in care. For this reason, there are currently no plans to undertake a national clinical audit for bladder cancer, though bladder cancer outcomes continue to be monitored through existing national cancer datasets.

Improving cancer outcomes, including for bladder cancer, is a priority for the Government. The forthcoming National Cancer Plan will set out further actions to improve earlier diagnosis, expand access to the latest treatments and technologies, and improve survival rates across England.

National cancer registry data shows a small but sustained decline in bladder cancer survival rates over recent years. One-year survival fell from approximately 72% to 69.6%, and five-year survival from 51.5% to 47.2% between 2007 to 2011 and 2016 to 2020.

To improve treatment times, we have invested £70 million of funding into new radiotherapy treatment machines to replace older, less efficient machines. These new machines are currently being rolled out to trusts throughout the country. These newer machines will reduce treatment times, boost productivity, and allow more patients to be seen over the same period.

In addition, non-specific symptom pathways have been introduced to speed up diagnosis for patients whose symptoms may indicate cancer but which do not align clearly with a specific tumour type. This helps ensure that more patients are referred, investigated, and diagnosed earlier, including cases of bladder cancer that present with broader or less specific symptoms.

The NHS Cancer Programme has commissioned 10 national clinical audits covering breast, ovarian, pancreatic, lung, prostate, oesophago-gastric, bowel, non-Hodgkin lymphoma, and kidney cancers. These were selected as auditing was expected to have the greatest impact on reducing unwarranted variation in care. For this reason, there are currently no plans to undertake a national clinical audit for bladder cancer, though bladder cancer outcomes continue to be monitored through existing national cancer datasets.

Research is crucial in tackling cancer, which is why the Department invests £1.6 billion each year on research through its research delivery arm, the National Institute for Health and Care Research (NIHR).

Between the 2020/21 and 2024/25 financial years, the NIHR committed £6 million for new research and programmes into bladder cancer research projects. An example of this investment includes a £2.9 million award for ‘Combination chemotherapy versus Bacillus Calmette-Guérin for high-risk non-muscle invasive bladder cancer a phase III multi-centre randomised controlled trial (COBRA)’. This study is researching whether gemcitabine and docetaxel delivered through intravesical therapy are typically recommended to patients who do not respond well to bacillus Calmette-Guerin treatment, a more common type of intravesical therapy that uses immunotherapy drugs to disrupt the processes that fuel bladder cancer growth.

The NIHR continues to welcome funding applications for research into any aspect of human health and care, including bladder cancer. These applications are subject to peer review and judged in open competition, with awards being made on the basis of the importance of the topic to the public and health and care services, value for money, and scientific quality.

The NHS Cancer Programme commissioned the Royal College of Surgeons to deliver six new clinical audits, in primary breast cancer, metastatic breast cancer, ovarian cancer, pancreatic cancer, non-Hodgkin lymphoma, and kidney cancer, on top of four existing audits in bowel, lung, oesophago-gastric, and prostate cancer. These audits were chosen because analysts considered that they are the cancers which audits would have the most potential to reduce unwarranted variation in treatment and outcomes. For these reasons, there are no plans to undertake a clinical audit for bladder cancer.

The National Cancer Plan will include further details on how we will improve outcomes for cancer patients, including those with bladder cancer, as well as speeding up diagnosis and treatment, ensuring patients have access to the latest treatments and technology, and ultimately bringing this country’s cancer survival rates back up to the standards of the best in the world.

The Department is committed to improving cancer care in all regions of England, including for bladder cancer patients. The National Health Service has exceeded their pledge to deliver an extra two million appointments, having now delivered over three million more appointments as the first step to ensuring earlier and faster access to diagnosis and treatment.

The National Cancer Plan, due for publication later this year, will include further details on how the NHS will improve care for bladder cancer patients, as well as speeding up diagnosis and access to treatment. Furthermore, it will ensure that patients have access to the latest treatments and technology. These actions will help bring this country’s cancer survival rates back up to the standards of the best in the world.

Reducing inequalities and variation in cancer diagnosis and treatment is a priority for the Government and will be included as a key area of focus in the plan.

The National Institute for Health and Care Excellence (NICE) is in the process of updating its guideline on the diagnosis and management of bladder cancer, following the NICE prioritisation board’s decision that this work should proceed. The NICE’s current guideline on the diagnosis and management of bladder cancer is available at the following link:

https://www.nice.org.uk/guidance/ng2

This work will be a partial update of the guideline, to include the recommendations on treating non-muscle invasive bladder cancer and muscle-invasive bladder cancer, and on managing locally advanced or metastatic muscle-invasive bladder cancer. NICE also plans to update the section of the guideline on diagnosing and staging.

NICE will set a provisional timeline for the update in due course and will share updates on its website as the update progresses.

I am sure my hon. Friend the Under-Secretary of State for Health and Social Care (Ashley Dalton), who is the Minister responsible for cancer, would be delighted to meet campaigners, particularly as we put together the national cancer plan. We want to ensure that we capture every type of cancer, and genuinely improve cancer care for everyone in our country.

This morning I attended an event about bladder cancer. Bladder cancer is the fifth highest killer in the United Kingdom, and people were anxious to meet the Minister and discuss those matters. Will he agree to meet bladder cancer organisations to take forward their four objectives to make things better for people in the United Kingdom?

As the hon. Member will know from my recent answer to Question 47566, Ministry of Defence (MOD) officials reviewed with interest the recent British Journal of Urology International research letter on a potentially increased risk of bladder cancer in military personnel exposed to explosive ordnance. This is a complex scientific area, and the MOD has referred this matter to the Independent Medical Expert Group (IMEG) for their independent medical advice. The possible link between exposure to explosives and an increased risk of bladder cancer among military personnel will be discussed by the IMEG at their June 2025 meeting and their advice will inform decisions on next steps.

I can confirm that no discussions have taken place with the Secretary of State for Health and Social Care. I am advised there is currently a lack of medical evidence to support screening this population for bladder cancer.

The National Institute for Health and Care Excellence (NICE) makes recommendations on whether new medicines should be funded by the National Health Service based on their costs and benefits. Wherever possible, NICE aims to align its processes with the regulatory process so that final guidance is published at, or around, the time that the treatment is granted a licence. The NHS in England is required to fund treatments recommended by NICE, normally within three months of guidance, and cancer medicines are eligible for funding from the Cancer Drugs Fund from the point of a positive draft recommendation.

NICE has four relevant technology appraisals in development or awaiting development currently: Durvalumab for neoadjuvant and adjuvant treatment of muscle-invasive bladder cancer, with development expected to start in April 2025 and earliest publication date February 2026; Durvalumab with enfortumab vedotin for neoadjuvant and adjuvant treatment of muscle-invasive bladder cancer when cisplatin is unsuitable, with development expected to start in October 2026 and earliest publication date August 2027; Durvalumab with Bacillus Calmette-Guerin (BCG) for treating high-risk non-muscle-invasive bladder cancer after resection of papillary tumours in people previously untreated with BCG, with timelines for this appraisal still to be confirmed as NICE is awaiting an update from the company regarding its preferred submission date; and Durvalumab with tremelimumab and chemotherapy for treating unresectable or advanced urothelial cancer, with development expected to start in January 2026 and earliest publication date October 2026.

The Department has not made a formal assessment of the policy implications following this clinical trial. The adoption of new treatments into the National Health Service in England is generally the result of National Institute for Health and Care Excellence guidance and commissioner decisions.

The recommended treatment plan for muscle-invasive bladder cancer depends on how far the cancer has spread. All hospitals use multidisciplinary teams to treat bladder cancer. These are teams of specialists that work together to make decisions about the best way to proceed with treatment.

We will get the National Health Service catching cancer on time, diagnosing it earlier and treating it faster so more patients survive this horrible set of diseases, including bladder cancer, and we will improve patients’ experience across the system.

Nationally, there is a focus on innovation and a move to develop new cancer tests. University Hospitals of North Midlands (UHNM) NHS Trust has been part of the Galleri trial of blood tests to identify cancer at the earliest stage. The trust is supporting the development of these trials and their adoptions as they are made available.

UHNM is working with primary care networks and other primary care stakeholders to outline a clear set of actions and milestones to improve referral practice, particularly for bowel, gynaecology and urology patients.

Whilst the Department will not make a specific estimate, the following link shows the number of diagnoses of bladder cancer in England for 2019 and 2020, the most recent years for which NHS Digital holds publicly available data:

https://digital.nhs.uk/data-and-information/publications/statistical/cancer-registration-statistics/england-2020/cancer-diagnoses-in-2020

NHS England (NHSE) has funded the following treatments for bladder cancer from the date of draft positive National Institute for Health and Care Excellence (NICE) guidance in the last 12 months:

- September 2021 - Atezolizumab for untreated PD-L1-positive advanced urothelial cancer when cisplatin is unsuitable

- April 2022 - Avelumab for maintenance treatment of locally advanced or metastatic urothelial cancer after platinum-based chemotherapy

- July 2022 - nivolumab for adjuvant treatment of invasive urothelial cancer at high risk of recurrence.

The NHSE Cancer Programme’s key approach to improving survival rates for cancer, including bladder cancer, is earlier diagnosis. One of the principal priorities, as set out in the NHS Long Term Plan, is to increase the proportion of cancers diagnosed at stages one and two to 75% by 2028. The latest NHS ‘Help Us Help You’ campaign focuses on the barriers to earlier presentation across all cancer types, and aims to address some of the underlying challenges to earlier diagnosis. This phase of the campaign has so far run during March and June 2022 and in both months saw 1,600% increases in the numbers of visits to the NHS website’s cancer symptoms page. NHSE’s plans include repeating the abdominal and urological symptoms campaign, which addresses symptoms relevant to bladder cancer.

Products containing active substances such as acetamiprid, cypermethrin and glyphosate are regulated as pesticides. This means that they may only be used if the active substances are approved and the products are authorised. Approval is only given if scientific assessment shows that at least one potential use of the substance will not harm people or pose unacceptable risks to the environment (including birds and mammals). Authorisation applies the same process to the proposed uses of the product. Conditions may be attached to authorisations to ensure that these safety standards are met (for example, the use of protective equipment by those using the pesticide).

The Forestry Stewardship Council (FSC) requirements for the control of forestry pests in certified operations include Integrated Pest Management (IPM) to avoid the use of pesticides. Where pesticides are needed as a last resort, the FSC has further measures in place to determine the lowest risk option. The Government is committed, under the 25 Year Environment Plan, to developing and promoting IPM across agriculture and other sectors where pesticides are currently used. This is being taken forward through the National Action Plan for the sustainable use of pesticides. The draft National Action Plan is currently out to pubic consultation and outlines steps to limit the use of pesticides and reduce their impacts.

The information requested is shown in the following table.

Number of people diagnosed with bladder cancer, England, 2013-17

In 2014, the government introduced a new duty on schools to support pupils with medical conditions and has published statutory guidance on this for schools and others to follow. The guidance can be found at: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3.

The guidance does not specify which medical conditions should be supported in schools. Instead, it focuses on the needs of each individual child and how their medical condition impacts on school life. It is clear that pupils at school with medical conditions should be properly supported so that they have full access to education.

The guidance is clear that schools, local authorities, health professionals, commissioners and other support services should work together to ensure that children with medical conditions receive a full education. I met with the Health Conditions in Schools Alliance earlier this year, which includes representation from CLIC Sargent to discuss this.

Schools also have duties under the Equalities Act 2010 to make reasonable adjustments and not to discriminate against disabled children, including those with long-term health conditions, such as bowel and bladder cancer in relation to their access to education and associated services. Schools must make reasonable adjustments to their practices, procedures and policies to ensure that they are not putting those with long-term health problems at a disadvantage.

There is currently limited information available on the long-term quality of life of patients treated for any cancer. Improving the information available was identified as a priority by the independent Cancer Taskforce in their report Achieving World-Class Cancer Outcomes published in July 2015. In partnership with Macmillan Cancer Support, NHS England is developing a new approach to data collection on Quality of Life that will inform a new Quality of Life metric. The approach will be piloted in 2017/18.

In December 2016, NHS England announced a fund of over £200 million available to Cancer Alliances over the next two years, specifically to support those areas of the Cancer Taskforce strategy that they estimated would need significant investment. This includes implementation of the Recovery Package so that patients have personalised care and support from the point they are diagnosed to improve their quality of life.