# Turkish urologists’ knowledge and attitudes on lifestyle advice for bladder cancer: a national survey

## TL;DR

Turkish urologists generally recognize the importance of lifestyle changes for bladder cancer patients but face barriers in implementing them in practice.

## Contribution

This study evaluates Turkish urologists' knowledge and attitudes toward lifestyle advice for bladder cancer patients through a national survey.

## Key findings

- Smoking is the most frequently addressed lifestyle factor by urologists, followed by fluid intake.
- Referral rates for lifestyle advice are low for non-smoking factors.
- Knowledge about ideal body weight and physical activity correlates with asking about lifestyle changes and giving advice.

## Abstract

To evaluate the knowledge level of Turkish urologists regarding the lifestyle changes related to bladder cancer and to what extent they question patients’ lifestyles and guide them in making recommended changes.

A 14-question online survey, based on a questionnaire prepared by Beeren et al. (Bladder Cancer 10(3):215-220, 2024), was sent to Turkish urologists. The survey included demographics, familiarity with guidelines, lifestyle assessment and advice, and perceived barriers during care for BC patients.

The mean age of the 252 participants was (44.8 ± 9.3), approximately 40% were affiliated with an academic hospital, and approximately 50% had more than 10 years of experience. Almost all were interested in uro-oncology, with 30% devoting more than half of their daily practice to uro-oncology. Smoking was reported as the most frequently questioned issue, for which advice was given and referrals to a lifestyle specialist provided when necessary. Asking about and giving advice regarding fluid intake came second, with approximately 50% mentioning this issue. Referral rates were low for lifestyle factors other than smoking. The most frequently reported barriers were a lack of information about where patients should be referred, insufficient motivation of patients, and concern about blaming patients.

There is a positive correlation between knowledge on ideal body weight and physical activity with asking about lifestyle changes (p = 0.004, p = 0.000), and giving lifestyle advice (p = 0.014, p = 0.003) and between knowledge on ideal body weight with referring for lifestyle advice and perception in lifestyle factors (p = 0.035, p = 0.016).

Lifestyle changes in bladder cancer patients are not sufficiently integrated into routine clinical practice by urologists. Although lifestyle changes are perceived as important by most urologists, they encounter some barriers in making these recommendations to their patients.