Other, less common types include squamous cell carcinoma and adenocarcinoma.
Bladder cancer is classified according to how deeply the abnormal cells have grown into the bladder wall and whether they have spread to nearby tissues or distant organs.
Non-muscle-invasive bladder cancer
This type has not grown into the bladder's muscular wall.
It may be found in the inner lining or the connective tissue immediately beneath it.
Many bladder cancers are diagnosed at this stage.
Although some non-muscle-invasive tumors can be treated successfully, they may return after treatment. Regular follow-up is therefore important.
Muscle-invasive bladder cancer
This type has grown into the muscular layer of the bladder wall.
It has a greater risk of spreading to surrounding structures or distant organs and usually requires more intensive treatment.
Metastatic bladder cancer
Metastatic bladder cancer has spread beyond the bladder to other parts of the body.
Common sites of spread include lymph nodes, bones, liver, and lungs.
Treatment depends on the extent of disease, the patient's overall health, and the characteristics of the tumor.
Who Is at Higher Risk of Developing Bladder Cancer?
Bladder cancer can affect adults of different ages, but certain factors increase the likelihood of developing the disease.
Understanding these risk factors can help people make informed decisions about their health.
1. Smoking
Smoking is one of the most important established risk factors for bladder cancer.
Tobacco contains chemicals that enter the bloodstream after inhalation.
The kidneys filter many of these substances from the blood and release them into urine. As urine remains in the bladder before being eliminated, the bladder lining may be exposed to harmful chemicals.
This exposure can damage cellular DNA and contribute to cancer development.
Both current and former smokers have an increased risk compared with people who have never smoked.
Quitting smoking can reduce future health risks and is beneficial at any age.
2. Increasing Age
Bladder cancer becomes more common with age.
Most cases are diagnosed in older adults, although younger people can also develop the disease.
The risk increases partly because cells accumulate genetic damage over time and may be exposed to harmful substances over many years.
3. Occupational Chemical Exposure
Certain industrial chemicals have been associated with an increased risk of bladder cancer.
People working in industries involving particular aromatic amines and other chemical compounds may have higher occupational exposure.
Examples of industries historically associated with increased risk include:
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Dye manufacturing.
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Rubber production.
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Leather processing.
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Certain textile operations.
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Chemical manufacturing.
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Some industrial painting and printing processes.
Workplace safety procedures, protective equipment, and appropriate exposure controls are important for reducing risk.
4. Previous Cancer Treatment
Certain chemotherapy medications, particularly cyclophosphamide, have been associated with an increased risk of bladder cancer.
Previous radiation therapy involving the pelvic region may also increase risk.
The risk depends on the treatment, dosage, and individual medical circumstances.
5. Chronic Bladder Irritation
Long-term irritation and inflammation of the bladder may be associated with certain forms of bladder cancer.
For example, chronic urinary catheter use and specific long-standing infections can contribute to risk in some circumstances.
Schistosomiasis, a parasitic infection affecting the urinary system, is an established risk factor for bladder squamous cell carcinoma in regions where the infection is common.
6. Family History and Genetic Factors
Having a close relative with bladder cancer may increase a person's risk, although most cases are not directly inherited.
Certain genetic variations and inherited cancer syndromes may contribute to susceptibility.
A family history should be discussed with a healthcare professional, especially when multiple relatives have developed cancer at relatively young ages.
How Is Bladder Cancer Diagnosed?
Recognizing symptoms is only the first step. A proper diagnosis requires medical evaluation.
If a healthcare professional suspects bladder cancer, several tests may be recommended.
Urine testing
A urine test can detect blood, signs of infection, and other abnormalities.
Urine cytology may also be used to look for abnormal cancer cells shed into the urine.
However, a normal urine test does not necessarily rule out bladder cancer.
Cystoscopy
Cystoscopy is one of the most important procedures used to examine the bladder.
A thin instrument with a small camera is inserted through the urethra into the bladder.
The doctor can inspect the bladder lining and look for suspicious growths or abnormal areas.
If a tumor is identified, additional procedures may be necessary to confirm the diagnosis.
Biopsy and transurethral resection
A procedure called transurethral resection of bladder tumor, or TURBT, is commonly used to remove visible tumors and obtain tissue samples.
The tissue is examined by a pathologist under a microscope.
This helps determine whether cancer is present, what type it is, and how deeply it has grown.
Imaging tests
Imaging studies help evaluate the urinary tract and determine whether the disease may have spread.
Depending on the situation, doctors may recommend: