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Bladder cancer

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Grading bladder cancer

To find out the grade of bladder cancer, the pathologist looks at a tissue sample from the bladder under a microscope. Doctors usually describe bladder tumours as high grade or low grade, but many pathologists still give bladder cancer a grade from 1 to 3 or 4. The lower the number, the lower the grade.

The grade is a description of the differentiation of the cancer cells. Differentiation is how the cancer cells look and behave compared to normal cells.

Low grade means that the cancer cells are well differentiated. They look and act much like normal cells. Lower grade cancer cells tend to be slow growing and are less likely to spread. Grade 1 is well differentiated and grade 2 is moderately well differentiated.

High grade means that the cancer cells are poorly differentiated, or undifferentiated. They look and act less normal, or more abnormal. Higher grade cancer cells tend to grow more quickly and are more likely to spread. Grade 3 is poorly differentiated and grade 4 is undifferentiated.

Knowing the grade gives your healthcare team an idea of how quickly the cancer may be growing and how likely it is to spread. This helps them plan your treatment. The grade can also help the healthcare team predict how you might respond to treatment.


Eleanor Rudd We realize that our efforts cannot even be compared to what women face when they hear the words ... ‘you have cancer.’

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