This summary of the 2026 European Association of Urology guideline on non-muscle-invasive bladder cancer (Ta, T1 and carcinoma in situ) was published in July 2026. The core message is unchanged: accurate risk stratification should drive treatment and follow-up.
The main additions are new tables on risk factors for bladder cancer and on prognostic factors for progression in histological subtypes; two new tables setting out treatment options for BCG-unresponsive tumours; a new section on adding immune checkpoint inhibitors to BCG in selected BCG-naive high- and very-high-risk patients; a table on the role of urinary markers in follow-up; and a section on pragmatic de-intensification of follow-up and treatment.
The abstract does not give the strength of each new recommendation, so readers should consult the full guideline before changing practice. Where BCG supply is constrained, the BCG-unresponsive tables and de-intensification guidance are likely to be the most immediately useful parts.
- Re-check your NMIBC risk-stratification tool against the 2026 EAU tables.
- Review the new BCG-unresponsive treatment tables before planning salvage options.
- Read the full guideline before adding checkpoint inhibitors to BCG; eligibility is selective.
- Look at the de-intensification section for low-risk follow-up schedules.
Why it matters
Checkpoint inhibitors with BCG and formal de-intensification move NMIBC care at both ends of the risk spectrum.
Don't overread it
This is a summary; check the strength of each recommendation in the full guideline before acting.
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