If healthy cells in your urinary bladder grow out of control and form a tumor or abnormal mass of tissue, you may develop bladder cancer.

The Centers for Disease Control and Prevention (CDC) estimates that 18,000 women and 57,000 men are diagnosed with bladder cancer each year in the United States.

While anyone can get bladder cancer, certain risk factors, like older age and being assigned male at birth, may increase the likelihood of developing this type of cancer.

This article provides an overview of the causes and risk factors of bladder cancer, including what leads to the progression to the advanced stage.

Bladder cancer affects the healthy tissues of the bladder. Most often, these cells begin to grow out of control and develop into a tumor.

In some cases, the abnormal growth stays in the bladder. But it can also spread to other parts of the body.

The most common type of bladder is urothelial carcinoma (transitional cell carcinoma), which starts in the urothelial cells that line the bladder, according to the American Cancer Society.

While not as common, other cancers that can start in the bladder include:

  • squamous cell carcinoma
  • adenocarcinoma
  • small cell carcinoma
  • sarcoma

Bladder cancer is the sixth most common type of cancer in the United States, but it ranks eighth in terms of types of cancer that lead to death.

Signs and symptoms can alert you to a possible problem. Tell your doctor if you experience any of the following symptoms:

  • blood in the urine, often the first sign of bladder cancer
  • pain or burning while urinating
  • frequent urination
  • feeling the urge to urinate even if the bladder isn’t full
  • pelvic pain
  • back pain

Bladder cancer is considered advanced when it progresses or spreads to other parts of the body.

According to the American Cancer Society, you may experience additional symptoms such as being unable to urinate, low back pain specific to one side, feeling tired or weak, loss of appetite and weight loss, and bone pain.

While the exact causes aren’t fully understood, experts agree several factors may increase the risk of developing bladder cancer.

Some causes are out of your control. But others, like smoking, are lifestyle factors you can change to decrease the risk of developing bladder cancer.

Understanding the causes of bladder cancer may help you identify risk factors and alert you to early warning signs.


Tobacco use is a significant risk factor for developing bladder cancer, according to the National Cancer Institute (NCI).

In fact, it’s the leading preventable cause of bladder cancer, with cigarette smoking being the highest tobacco risk. About half of all bladder cancers have smoking as the leading risk factor, per the American Cancer Society.

Tobacco smoke is full of chemicals that can damage the lining of the bladder. Over time, this exposure can lead to the development of cancerous cells.

Advanced age

You can develop bladder cancer at any age, but it’s more common when you’re older. The American Cancer Society says that the majority of people with bladder cancer are over age 55, with the average age of diagnosis being 73.

Being assigned male at birth

The CDC estimates that about 12,000 men die from the disease each year, compared to 4,700 women. Moreover, the American Cancer Society estimates that men have about a 1 in 28 chance of developing bladder cancer, while women have a 1 in 91 chance.

Family history of bladder cancer

If you have a family member with bladder cancer, you may be at an increased risk of developing the disease. This may be caused by exposure to similar cancer-causing chemicals like those found in tobacco or an industrial setting.

You may also share the same changes in genes that make it difficult to break down certain toxins, according to the American Cancer Society. Although, unlike other cancers, bladder cancer doesn’t often run in families.

Exposure to certain chemicals

Frequent exposure to certain cancer-causing chemicals, including dyes, rubber, leather, textiles, paint, and printing material can increase your risk of developing bladder cancer.

According to the American Cancer Society, exposure is most common in the workplace, especially in industrial settings that use certain organic chemicals.

Beyond the risk factors above, there are others to be aware of, including:

  • having chronic bladder infections and irritations, including kidney and bladder stones, and urinary infections
  • taking certain medications or previous chemotherapy with a drug called Cytoxan
  • having had radiation to treat cancer in the pelvis
  • consuming arsenic in drinking water (not a significant factor in the United States)
  • not drinking enough water
  • being white
  • having a history of bladder cancer

Like other cancers, some people diagnosed with bladder cancer have no identifiable risk factors. On the other hand, some people considered high risk may never develop the disease.

That’s why it’s important to maintain good overall health and seek medical attention if you experience symptoms such as blood in the urine or frequent urination.

When diagnosed and treated early, bladder cancer has a favorable survival rate.

That said, if the disease is untreated, resistant to treatments, or spreads, it may progress to an advanced stage. This typically happens when the cancer cells grow and invade the deeper layers of the bladder wall or spread to nearby lymph nodes or other organs.

Your doctor will likely assign a stage at the time of diagnosis. Bladder cancer stages include stages 1, 2, 3, and 4. Stage 4 is the most advanced form and is often referred to as metastatic bladder cancer.

At stage 4, the cells travel through the lymphatic system and form tumors in other areas of the body. While it’s not one of the deadliest forms of cancer, it can still lead to death.

Several factors contribute to advanced-stage bladder cancer. But some contribute to the progression and increase the risk of mortality more than others. They include:

  • delayed diagnosis
  • stage at diagnosis
  • risk factors such as smoking
  • older age
  • recurrent tumor
  • high-grade tumors

Several risk factors like smoking, age, gender, and exposure to certain chemicals can raise your chances of developing bladder cancer. While some are preventable, others you can’t change. That’s why it’s critical to maintain a healthy lifestyle and see your doctor for regular screenings.

Early detection and treatment of bladder cancer can help prevent its progression to an advanced stage.