Han DS, et al. - Through a validated natural language processing algorithm of subjects with newly diagnosed with low-risk (ie low-grade Ta) non–muscle-invasive bladder cancer (NMIBC) from 2005 to 2011 in the Veterans Affairs (VA), the experts intended to discover cystoscopic surveillance practice in such individuals within the VA. Follow-ups were taken until cancer recurrence, death, last contact, or 2 years post-diagnosis. With an abundance of 1,846 more cystoscopies done than suggested, overuse was observed in 75% of patients. Post-adjustment of 14 factors, overuse was correlated with patient race, who had 2 comorbidities, and earlier year of diagnosis. Overuse still happened in 45% of patients, on sensitivity analyses considering all patients with a diagnosis of multifocal or large low-grade tumors (intermediate-risk). Hence, in subjects with low-risk NMIBC, overuse of cystoscopy was generally seen which raised concerns regarding bladder cancer surveillance cost and quality. However, an association of few factors with overuse was ascertained. Therefore, in order to recognize other determinants of overuse that were not easily captured in administrative data, more qualitative research is required.