Meeting of the Parliament 10 September 2025
I refer members to my entry in the register of members’ interests, as I am a practising NHS GP.
I thank Stuart McMillan for bringing this underknown cancer to debate. Bladder cancer is the 11th most common cancer in the UK, with around 60 people diagnosed every day according to Action Bladder Cancer UK, and yet outcomes remain uneven. In Scotland, five-year survival continues to fall short compared with the rest of the UK, and with much of Europe. That is not because our clinicians lack dedication or expertise, but because too many cases are diagnosed too late, and because services across the country are stretched.
So, what can we do? The first and most important step is to raise awareness. We have heard already that blood in the urine—even once—must never be ignored. If you have persistent urinary symptoms or, basically, if anything changes as you go to the toilet, you want to seek some help. If people recognise those warning signs, getting early help can absolutely help against cancer. The one thing that I would love to say—and I think that all of us across the chamber would agree with this—is: if things change in your body, or you find that that change does not go away, come and speak to a GP. We are a friendly bunch, and we will be happy to hear what is going on.
But awareness on its own cannot close the gap. Diagnosis and treatment depend on having the right staff, equipment and capacity in place. Across Scotland, GPs, nurses, urological surgeons, oncologists, radiologists and many others provide extraordinary care under great pressure.
There is some good reason for optimism. At the University of Dundee, researchers have developed a light-based test that detects certain chemicals in the urine. In trials, that test was accurate more than eight times out of 10, and it requires only a urine sample. At the University of Edinburgh, researchers are exploring ways to personalise bladder cancer treatment by studying biological markers and advancing imaging features, and they are working to match therapies more closely to each patient’s individual tumour. Elsewhere, a study funded by Cancer Research UK, with the University of Birmingham and industry partners, has shown that a new urine-based test can detect tumour DNA in 87 per cent of cases. That technology could reduce the need for repeated invasive camera examinations, which are often uncomfortable. Such innovation, whether at Dundee or Edinburgh university, or through partnership across the rest of the UK, is already changing what is possible.
Artificial intelligence is another emerging tool. AI systems are showing promise in reading scans and analysing pathology results. With appropriate safeguard, those tools could help clinicians identify high-risk patients more quickly, and prevent any delays. Scotland is well placed to take and play a leading role in integrating AI responsibly into clinical practice.
Alongside clinical advances, we must also recognise the vital role that charities and patient organisations play. For example, Fight Bladder Cancer supports patients and families, raises awareness, and ensures that the patient voice is heard in policy and research. That work reminds us that progress is about not only survival stats, but dignity, reassurance and hope.
The priorities, then, are clear. We need stronger public awareness of symptoms, sustained investment in staff and resources across primary and secondary care, commitment to research and innovation, and deeper partnership with charities and communities.
By bringing all those elements together, we can change the story of not only bladder cancer but all cancers in Scotland: we can improve survival, reduce variation in care and ensure that every patient has the best possible chance. That is not about adding to clinical workload, but about building capacity, sharing knowledge and empowering patients. With focus and collaboration, Scotland can move from lagging behind to leading the way in bladder cancer care.
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