What are the risk factors for urinary bladder cancer?

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Last updated: May 15, 2025View editorial policy

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From the Guidelines

Bladder cancer risk factors include smoking, which is the most significant modifiable risk factor, as well as exposure to certain industrial chemicals, age, sex, and genetic factors, all of which contribute to the development of bladder cancer by causing DNA damage in bladder cells. The most recent and highest quality study, 1, highlights that risk factors for developing bladder cancer include male sex, white race, smoking, personal or family history of bladder cancer, pelvic radiation, environmental/occupational exposures, exposure to certain medications, chronic infection or irritation of the urinary tract, and certain medical conditions, including obesity and diabetes. Some key points to consider are:

  • Smoking is the most important risk factor for bladder cancer, with an immediate decrease in risk observed for those who stop smoking, dropping by 60% at 25 years after cessation 1
  • Occupational exposure to chemicals used in dyes, rubbers, textiles, paints, and leathers also increases the risk of bladder cancer 1
  • Age is a major factor, with most diagnoses occurring after age 55, and men have a higher risk than women, with white individuals being more likely to develop bladder cancer than other racial groups 1
  • Chronic bladder inflammation, such as from recurrent urinary tract infections or bladder stones, can increase risk, and previous cancer treatments including cyclophosphamide chemotherapy or pelvic radiation therapy are associated with higher bladder cancer rates 1
  • Genetic factors play a role, with a family history increasing risk by about twice, and certain genetic syndromes, such as Lynch syndrome, may also predispose an individual to urothelial carcinoma 1

From the Research

Bladder Cancer Risk Factors

  • Smoking is the strongest established risk factor for bladder cancer 2, 3
  • Former smokers have a lower risk of bladder cancer compared with current smokers, but the risk remains higher than never smokers even after 30 years of quitting 2
  • Smoking cessation is critical to prevent the incidence of bladder cancer in older women 2
  • Smoking is associated with an increased risk of recurrence in patients with nonmuscle-invasive bladder cancer (NMIBC) and may impair Bacillus Calmette-Guerin treatment efficacy 3
  • Smoking is associated with poor responses to neoadjuvant chemotherapy, poor survival outcomes, and high complication rates in patients undergoing radical cystectomy 3

Treatment-Related Risk Factors

  • Patients failing Bacillus Calmette-Guérin (BCG) treatment have a poor prognosis, and cystectomy is then the recommended treatment 4
  • BCG treatment is associated with more local and systemic side-effects compared to intravesical chemotherapy 4
  • Maintenance BCG is required to achieve the best therapeutic results, but the optimal dose, induction, and maintenance schedules, and duration of treatment are unknown 4

Other Risk Factors

  • No other risk factors are mentioned in the provided studies, but it is known that bladder cancer risk is influenced by various factors, including genetic and environmental factors. However, the provided studies do not discuss these factors in detail.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Smoking Cessation and the Risk of Bladder Cancer among Postmenopausal Women.

Cancer prevention research (Philadelphia, Pa.), 2019

Research

Bacillus Calmette-Guérin treatment of non-muscle invasive bladder cancer.

International journal of urology : official journal of the Japanese Urological Association, 2011

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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