Bladder Cancer: Risk Factors, Symptoms, Screening

Men are more prone to get bladder cancer than women. According to the American Cancer Society (ACS), a man’s chance of developing bladder cancer is 1 in 28.

“While the rates of new bladder cancers and deaths from bladder cancer have been dropping in recent years, did you know that men are 4 times more likely to get bladder cancer than women?” says Richard Lee, MD, PhD, an oncologist and clinical co-director of the Claire and John Bertucci Center for Genitourinary Cancers at Mass General Cancer Center.

Dr. Lee encourages patients to become familiar with the symptoms of bladder cancer to detect it earlier. In this article, Dr. Lee describes bladder cancer risk factors, symptoms, screening, and steps patients can take to help reduce the risk of having this disease.

What is bladder cancer?

Your bladder is the hollow organ in your lower abdomen that stores urine. The kidneys make urine, and then it moves to the bladder. The kidneys and bladder work together to remove toxins and waste from your body, and to clean the blood. After the bladder stores urine, it goes through the urethra to be released.

Bladder cancer typically starts in cells lining the bladder. As cancer grows, it goes through the deeper layers of the bladder wall. If not detected and treated on time, bladder cancer can spread to the lymph nodes, the bones, the lungs, or the liver.

Bladder cancer risk factors

Several factors can influence your risk of getting bladder cancer, but most bladder cancers are developed by men and older adults.

“Bladder cancer is most common in older adults, but you can get it at any age,” affirms Dr. Lee. Besides sex and age, smoking is the biggest risk factor for men and women. In fact, almost half of all bladder cancers are found in current or former smokers according to the National Library of Medicine (NIILM).

Remember that a risk factor doesn’t mean you will get bladder cancer. Some people with no risk factors also may develop bladder cancer. Talk to your primary care doctor (PCP) if you’re concerned about having bladder issues or notice unusual changes.

Risk factors you cannot change

The Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NIH) recommend learning about the risk factors for bladder cancer you can and can’t control to make decisions that might lower the risk of getting the disease.

The risk factors you can’t change include:

• Race and ethnicity. White people are at increased risk of bladder cancer compared to Black people.

• Older age. According to the American Cancer Society, 9 out of 10 people with bladder cancer are over the age of 55.

• Be male or assigned male at birth

• Have a chronic bladder irritation and infection

• Bladder birth defects. Some babies are born with birth defects like urachus or exstrophy, where the belly button and the abdominal wall didn’t close completely. This can increase the risk of getting bladder cancer after birth, but these birth defects are extremely rare.

• Have a family history of bladder cancer

• A past treatment of chemotherapy or radiation therapy

Risk factors you can change

• Smoking

• Not drinking enough water

• Taking herbal supplements, like aristolochic acid, is linked to increased risk of bladder cancer

• Exposure to chemicals in the workplace such as paints, dyes, metals, petroleum, and textiles

How can you reduce your risk of bladder cancer?

While there is no proven way to prevent bladder cancer, you can take these steps to help lower your risk:

• Quit smoking. This is the most important risk factor. Talk to your doctor to find support to quit smoking. You can also find tips to quit smoking.

• Stay hydrated. Drinking plenty of fluids can reduce the risk of getting bladder cancer.

• Eat a healthy diet. The ACS suggests that including fruits and vegetables to your regular diet may help to reduce the risk of bladder cancer in addition to other health benefits.

Bladder cancer signs and symptoms

Bladder cancer symptoms include:

• Bloody urine. This is the most common symptom of bladder cancer. Blood turns urine a rusty or bright red color. If you see signs of blood in your urine, it’s important to call your doctor.
  
  
• Frequent, painful, or burning urination

• The urge to go even when your bladder isn’t full

• Frequent urination at night

“Not everyone with bladder cancer will have noticeable blood in their urine. We can also use a urine test to detect microscopic amounts of blood,” states Dr. Lee.

Bladder cancer screening

Doctors commonly perform three evaluations if you have blood in your urine:

1. A urine test to look for abnormal cells in the bladder


2. A CT urogram, an imaging test that provides detailed pictures of your bladder


3. A cystoscopy performed by a urologist, a doctor focused on problems of the urinary system. “During this procedure, your provider inserts a long, thin tube called a cystoscope into your urethra. That’s the hole where urine comes out. The cystoscope has a tiny camera that lets your doctor see inside your bladder,” says Dr. Lee. 

If doctors are concerned about the possibility of bladder cancer after any of the initial three tests, they may perform a biopsy. In a biopsy, your doctor may remove a small amount of tissue from your bladder to test for bladder cancer.

“While the three evaluations aid in the diagnosis, only the biopsy will prove that there is cancer in the bladder,” affirms Dr. Lee.

“The good news is that we detect most bladder cancer before it spreads, when it’s easier to treat,” says Dr. Lee. “Early detection can lead to easier treatment and bladder preservation so you can continue to urinate normally.”