Bladder cancer is a type of cancer that starts in the bladder. The bladder is an organ in your pelvis that stores urine before it leaves your body.

About 68,000 adults in the United States are affected by bladder cancer each year, making it one of the most common cancers.

Read on to learn if you’re at risk for developing bladder cancer.

Certain things may raise your chances of developing bladder cancer. These are called risk factors. It’s important to know the risk factors so you can avoid them if possible. On the other hand, some people may have several risk factors, but never develop this cancer.

Following are 13 risk factors for bladder cancer.

1. Smoking

People who smoke are at least three times as likely to develop bladder cancer as those who don’t. Smoking is blamed for about half of all bladder cancer in men and women. In fact, studies have found it’s the most common risk factor for this cancer.

When you smoke, harmful chemicals can accumulate in the urine and damage the lining of your bladder. That could lead to cancer. Avoid all cigarettes, cigars, and pipes to lower your risk of developing bladder cancer. Here are tips to help you stop smoking.

2. Arsenic in water

Several studies have suggested that ingesting high amounts of arsenic in drinking water is linked to a greater risk of bladder cancer. Researchers aren’t exactly sure why exposure to this element is related to cancer. Most of the drinking water in the United States contains low levels of arsenic, but this may be a concern for people in other parts of the world.

3. Workplace chemicals

Certain chemicals that are used in the workplace have been associated with a higher chance of developing bladder cancer. Studies estimate that occupational exposure to chemical agents is responsible for 18 percent of bladder cancer cases.

Doctors believe contact with certain agents leads to bladder cancer because your kidneys help filter harmful chemicals from your bloodstream and distribute them into your bladder.

Substances used in the manufacturing of rubber, dyes, leather, and paint products are thought to affect your risk of bladder cancer. Some of these chemicals include benzidine and beta-naphthylamine, which are known as aromatic amines.

You’re at an increased risk for bladder cancer if you work in the following professions:

  • painter
  • hairdresser
  • machinist
  • truck driver

That’s because people in those professions are exposed to harmful chemicals on a regular basis.

4. Medicines

Certain drugs have been linked to bladder cancer. The U.S. Food and Drug Administration warns that taking the diabetes medication pioglitazone (Actos) for more than a year may raise a person’s risk of developing this cancer. Other studies have shown no connection between use of the medicine and bladder cancer.

Cancer treatments, such as the chemotherapy drug cyclophosphamide (Cytoxan, Neosar) or radiation therapy, may also raise the risk of bladder cancer. Talk to your doctor if you have any concerns about the medicines you’re taking.

5. Supplements

Dietary supplements that contain aristolochic acid may put you at risk for developing bladder cancer. This compound is often found in herbal products to help:

  • arthritis
  • gout
  • inflammation
  • weight loss

Avoid supplements that contain aristolochic acid to reduce your risk.

6. Dehydration

Not drinking enough fluids may be a risk factor for bladder cancer. Researchers think people who drink plenty of water each day empty their bladders more often, which may keep harmful chemicals from sticking around in the bladder.

While guidelines vary, in general, men should drink about 13 cups of liquids a day. For women, it’s about 9 cups a day. Learn more about how much water you should drink per day.

7. Family history of certain conditions

If you have a family history of bladder cancer or the hereditary condition nonpolyposis colorectal cancer, also known as “Lynch syndrome,” you might be at an increased risk for bladder cancer. Certain mutations, such as those of the RB1 gene and the PTEN gene, may also boost your chances of having this cancer. Learn more about the connection between bladder cancer and genetics.

8. Bladder problems

Certain bladder problems have been linked to bladder cancer, including:

Schistosomiasis, an infection caused by a parasitic worm, also increases your chances of developing this cancer. This parasite is very rare in the United States.

9. Race

Caucasians are twice as likely as African-Americans or Hispanics to develop bladder cancer. Experts aren’t sure why this link exists.

10. Gender

Bladder cancer affects more men than women. In fact, men are three to four times more likely to get this cancer during their lifetime.

11. Age

Most cases of bladder cancer occur in older individuals. About 9 out of 10 people with this cancer are older than age 55. The average age that most people develop bladder cancer is 73.

12. History of bladder or urothelial cancer

Having cancer anywhere in your urinary tract puts you at risk for another episode of cancer, even if your tumor was removed. If you’ve had bladder cancer in the past, your doctor will likely follow you carefully to make sure new cancers haven’t developed.

13. Bladder birth defects

People who are born with bladder birth defects might be more likely to develop bladder cancer. But these problems are rare.

You might be able to prevent bladder cancer by avoiding certain lifestyle behaviors. One of the most important changes you can make is to stop smoking. Also, try to avoid exposure to chemicals and dyes. Additionally, drinking plenty of water is another potential way to prevent bladder cancer.

Be sure to talk to your doctor if you think you’re at risk for bladder cancer or if you have a family history of this disease. Your healthcare provider may want to perform certain screening tests.

Some early signs of bladder cancer include:

  • blood in your urine
  • painful or frequent urination
  • pelvic or back pain

Your doctor may diagnose bladder cancer by performing these tests:

  • Cystoscopy: This involves inserting a small, narrow tube, called a cystoscope, through your urethra. The device has a lens on it that lets doctors see inside your bladder to look for signs of cancer.
  • Biopsy: During a cystoscopy, your doctor might collect a small sample of tissue for testing. This process is known as a biopsy.
  • Urine cytology: With this procedure, a small sample of urine is analyzed under a microscope to check for cancer cells.
  • Imaging tests: Various imaging tests, including a CT urogram, retrograde pyelogram, ultrasound, or MRI scan, can be done to let your doctor see areas in your urinary tract.
  • Urinalysis: This simple test detects blood and other substances in your urine.

Many risk factors can raise your chances of developing bladder cancer. Avoiding certain harmful behaviors, especially smoking, may protect you from the disease. Still, people without risk factors can develop bladder cancer.

Maintaining a healthy lifestyle and visiting your doctor for regular screenings can help lower your risk and ensure early detection if you do develop bladder cancer.