Risks for bladder cancer

Last medical review:

Certain behaviours, substances or conditions can affect your risk, or chance, of developing cancer. Some things increase your risk and some things decrease it. Most cancers are the result of many risks. But sometimes cancer develops in people who don't have any risks.

Smoking tobacco is the main risk for bladder cancer.

The risk of developing bladder cancer increases with age. It usually occurs in people older than 65 years of age. Bladder cancer is most common in Caucasians, and men develop this disease more often than women.

The following can increase or decrease your risk for bladder cancer. There are things you can do to lower your risk and help protect yourself from developing cancer.

Smoking tobacco

Arsenic

Contact with chemicals at work

Aristolochic acids

Opium

Previous chemotherapy

Previous radiation therapy

Chronic bladder irritation

Personal history of cancer in the urinary tract

Bladder birth defects

Lynch syndrome

Smoking tobacco

Smoking tobacco increases your risk for bladder cancer. All forms of tobacco, including cigarettes, cigars, pipes and smokeless (spit) tobacco, increase your risk. The more you smoke and the longer you smoke, the greater your risk. The risk of developing bladder cancer decreases with time after you quit smoking.

Learn more about how to live smoke-free.

Arsenic

Arsenic is a substance found in nature. Sometimes drinking water can be contaminated with high levels of arsenic, which increases the risk for bladder cancer. The arsenic can come from natural sources, such as rocks and soil. It can also come from certain types of mining, smelting or manufacturing plants.

Learn more about arsenic and cancer.

Contact with chemicals at work

Workers in the following industries have a higher risk of developing bladder cancer:

  • professional painting
  • rubber manufacturing
  • aluminum and metal production
  • textile and dye manufacturing
  • transportation

This higher risk is linked to exposure to certain chemicals. Your risk is especially high if you are exposed to aromatic amines, including 2-naphthylamine, benzidine, 4-aminobiphenyl and o‑toluidine. Exposure to polycyclic aromatic hydrocarbons (PAHs), 2-mercaptobenzothiazole, and chemicals used to produce magenta dye also increase the risk for bladder cancer.

Hairdressers who worked prior to 1980 may have been exposed to 4-aminobiphenyl and o-toluidine in permanent hair dyes. These chemicals are no longer used in hair dyes.

People who smoke tobacco and are exposed to these chemicals in the workplace have an even higher risk of developing bladder cancer.

Learn more about what you can do to be safe at work.

Aristolochic acids

Aristolochic acids are found naturally in several types of plants. These plants may be used in some traditional Chinese medicines that treat arthritis and other diseases caused by inflammation in the body.

People who take herbal products with aristolochic acids have a higher risk for bladder cancer, as well as greater risk for kidney damage.

Opium

Opium is a highly addictive drug used in medicine to relieve pain. It is also used illegally. Consuming opium increases your risk of developing bladder cancer.

Previous chemotherapy

People who have been treated with the chemotherapy drug cyclophosphamide (Procytox) or ifosfamide have a higher risk for bladder irritation, which in turn increases the risk of developing bladder cancer.

To help protect the bladder, it is important to drink plenty of fluids during treatment with cyclophosphamide or ifosfamide. Sometimes doctors will give other drugs to help protect the bladder from irritation.

Previous radiation therapy

People who received radiation therapy to the abdomen or pelvis have a higher risk for bladder cancer. People who are exposed to radiation at work or who have survived atomic bombs or nuclear accidents also have a higher risk for bladder cancer.

Chronic bladder irritation

If you often have bladder irritation, or if bladder irritation lasts a long time, you have a higher risk for bladder cancer. Chronic bladder irritation can be caused by inflammation or injury. Inflammation can be caused by bladder stones or chronic bladder infections.

Schistosoma haematobium (S. haematobium) is a parasitic worm that infects the bladder and causes inflammation (called schistosomiasis or bilharzia). This type of bladder infection occurs most often in developing countries. Chronic infection with S. haematobium increases the risk for bladder cancer.

The bladder can be injured by having a catheter in for a long time, which some people need to help them empty their bladders.

Personal history of cancer in the urinary tract

Having a cancer in any part of the urinary tract increases the risk of developing another tumour in the urinary tract, including in the bladder.

Bladder birth defects

Urachus and exstrophy are rare birth defects that increase a person’s risk of developing bladder cancer.

The urachus is the connection between the navel, or belly button, and the bladder. It develops in a fetus and remains as a thin strip of fibrous tissue in an adult. The urachus can become cancerous if a cyst forms along it or if it remains partly open.

Exstrophy is when skin, muscle and connective tissue in front of the bladder do not close completely during development and leave a hole in the wall of the bladder. The inside of the bladder can be exposed to micro-organisms. This exposure can lead to chronic infections, which increase the risk for bladder cancer. Doctors treat exstrophy as soon as it is found, but people with this birth defect have a higher risk of developing bladder cancer throughout their lives.

Lynch syndrome

Lynch syndrome is an inherited condition that causes a large number of polyps to develop in the lining of the colon and rectum, but not as many polyps as are found in familial adenomatous polyps (FAP). Lynch syndrome is also called hereditary non-polyposis colorectal cancer (HNPCC).

There are 2 types of Lynch syndrome. Type A increases the risk for colorectal cancer. Type B increases the risk for several cancers, including colorectal cancer, other cancers of the digestive system and cancers of the urinary tract, such as bladder cancer.

Possible risks

The following have been linked with bladder cancer, but there is not enough evidence to know for sure that they are risks. More research is needed.

  • disinfection by-products

  • family history of bladder cancer
  • outdoor air pollution
  • pesticides
  • diesel engine exhaust
  • certain medicines, such as phenacetin and pioglitazone
  • not eating enough fruits and vegetables
  • physical inactivity

No link to bladder cancer

Significant research shows no link between bladder cancer and alcohol, artificial sweeteners or coffee.

Understanding your cancer risk

To make the decisions that are right for you, ask your doctor questions about risks. Learn how cancer can be prevented and what you can do to reduce your risk.

Expert review and references

  • Canadian Cancer Society | Société canadienne du cancer
  • Di Lorenzo G, Federico P, De Placido S, Buonerba C . Increased risk of bladder cancer in critical areas at high pressure of pollution of the Campania region in Italy: A systematic review. Critical Reviews in Oncology Hematology. 2015.
  • Wischhusen JW, Ukaegbu C, Dhingra TG, Uno H, Kastrinos F, Syngal S, et al . Clinical factors associated with urinary tract cancer in individuals with Lynch syndrome. Cancer Epidemiology, Biomarkers and Prevention. 2020: https://cebp.aacrjournals.org/content/29/1/193. lacinilC.
  • Grosse Y, Loomis D, Guyton KZ, El Ghissassi F, Bouvard V, Benbrahim-Talla L, Mattock H, Straif K . Carcinogenicity of some industrial chemicals. Lancet Oncology. 2016.
  • International Agency for Research on Cancer (IARC). Volume 100A: Pharmaceuticals: a review of human carcinogens. 2012: https://publications.iarc.fr/118.
  • International Agency for Research on Cancer (IARC). Volume 100A-23: Plants containing aristolochic acid. 2018: https://monographs.iarc.who.int/wp-content/uploads/2018/06/mono100A-23.pdf.
  • IARC monographs evaluate the carcinogenicity of opium consumption. International Agency for Research on Cancer, World Health Organization. IARC Press Releases. France: 2020.
  • Sheikh M, Shakeri R, Poustchi H, Poushams A, Etemadi A, et al. Opium use and subsequent incidence of cancer: results from the Golestan Cohort Study. Lancet Global Health. 2020: 8:e649–60. https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(20)30059-0.pdf. Wednesday, September 15, 2021.
  • Silverman DT, Koutros S, Figueroa JD, Prokunina-Olsson L, Rothman N. Bladder cancer. Thun MJ, Linet MS, Cerhan JR, Haiman CA Schottenfeld D, eds.. Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. 4th ed. New York, NY: Oxford University Press; 2018: 52.
  • International Agency for Research on Cancer (IARC). Volume 84: Some drinking-water disinfectants and contaminants, including arsenic. France: World Health Organization; 2004.
  • International Agency for Research on Cancer (IARC). Volume 61: Schistosomes, liver flukes and Helicobacter pylori. 1994: http://monographs.iarc.fr/ENG/Monographs/vol61/mono61.pdf.
  • International Agency for Research on Cancer (IARC). Volume 26: Some antineoplastic and immunosuppressive agents. 1988: http://monographs.iarc.fr/ENG/Monographs/vol1-42/mono26.pdf.
  • International Agency for Research on Cancer (IARC). Volume 98: Painting, firefighting and shiftwork. 2010: http://monographs.iarc.fr/ENG/Monographs/vol98/mono98.pdf.
  • International Agency for Research on Cancer (IARC). Volume 92: Some non-heterocyclic polycyclic aromatic hydrocarbons and some related exposures. 2010: http://monographs.iarc.fr/ENG/Monographs/vol92/mono92.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100A: Pharmaceuticals - A Review of Human Carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100C: Arsenic, metals, fibres and dusts: a review of human carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100C/mono100C.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100D: Radiation: A Review of Human Carcinogens. 2011: http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100E: Personal Habits and Indoor Combustions. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100E/mono100E.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100F: Chemical Agents and Related Occupations: A Review of Human Carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100F/index.php.
  • International Agency for Research on Cancer (IARC). Volume 101: Some chemicals present in industrial and consumer products, food and drinking-water. 2012: http://monographs.iarc.fr/ENG/Monographs/vol101/mono101.pdf.
  • International Agency for Research on Cancer (IARC). Volume 105: Diesel and gasoline engine exhausts and some nitroarenes. 2013: http://monographs.iarc.fr/ENG/Monographs/vol105/mono105.pdf.
  • International Agency for Research on Cancer (IARC). Volume 108: Some drugs and herbal products. 2014: http://monographs.iarc.fr/ENG/Monographs/vol108/index.php.
  • Kamangar F, Shakeri R, Malekzadeh R, Islami F . Opium use: an emerging risk factor for cancer?. Lancet Oncology. 2014.
  • Kogevinas M, Montserrat G, and Trichopoulos D . Urinary bladder cancer. Adami, H.-O., Hunter, D., & Trichopoulos, D. Textbook of Cancer Epidemiology. 2nd ed. Oxford: Oxford University Press; 2008: 573-596.
  • Koutros S, Silverman DT, Alavanja MC, Andreotti G, Lerro CC, Heltshe S, Lynch CF, et al . Occupational exposure to pesticides and bladder cancer risk. International Journal of Epidemiology. 2015.
  • Lewis JD, Habel LA, Quesenberry CP, Strom BL, Peng T, Hedderson MM, Ehrlich SF, et al . Pioglitazone use and risk of bladder cancer and other common cancers in persons with diabetes. JAMA. 2015.
  • Loomis D, Guyton KZ, Grosse Y, Lauby-Secretan B, El Ghissassi F, Bouvard V, et al . Carcinogenicity of drinking coffee, mate, and very hot beverages. Lancet Oncology. 2016.
  • Mackenzie TA, Zaha R, Smith J, Kargas MR, Morden NE . Diabetes pharmacotherapies and bladder cancer: a medicare epidemiologic study. Diabetes Therapy. 2016.
  • Noguchi JL, Liss MA, Parsons JK . Obesity, physical activity and bladder cancer. Current Urology Reports. 2015.
  • Poon SL, Huang MN, Choo Y, McPherson JR, Yu W, Heng HL, et al . Mutation signatures implicate aristolochic acid in bladder cancer development. Genome Medicine. 2015.
  • Sun JW, Zhao LG, Yang Y, Ma X, Wang YY, Xiang YB . Obesity and risk of bladder cancer: a dose-response meta-analysis of 15 cohort studies. PLoS One. 2015.
  • Turati F, Bosetti C, Polesel J, Zucchetto A, Serraino D, Montella M, Libra, M, et al . Coffee, tea, cola, and bladder cancer risk: dose and time relationships. Urology. 2015.
  • Turati F, Pelucchi C, Galeone C, Decarli A, La Vecchia C . Personal hair dye use and bladder cancer: a meta-analysis. Annals of Epidemiology. 2014.
  • World Cancer Research Fund and American Institute for Cancer Research. Continuous Update Project Report: Diet, Nutrition, Physical Activity and Bladder Cancer. 2015: http://wcrf.org/bladder-cancer-2015.
  • Wu W, Ton Y, Zhao Q, Yu G, Wei X, Lu Q . Coffee consumption and bladder cancer: a meta-analysis of observational studies. Scientific Reports. 2015.
  • Zhang H, Jiang D, Li X . Use of nonsteroidal anti-inflammatory drugs and bladder cancer risk: a meta-analysis of epidemiologic studies.. PLoS One. 2013.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.

The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on cancer.ca, nor do we endorse any service, product, treatment or therapy.


1-888-939-3333 | cancer.ca | © 2024 Canadian Cancer Society