People who have had bladder cancer or are at high risk of bladder cancer should have regular screening tests. These include urine analysis, urine cytology, and urine tests for tumor markers.
As is true of all cancers, bladder cancer has the best treatment options and the best survival rates when it’s diagnosed early. While screening can help find bladder cancer in its early stages, no standard bladder screening is currently available.
Researchers are developing tests that could help screen for bladder cancer in the future, but current screening options are only available for people who’ve had bladder cancer in the past or who have a very high risk of bladder cancer.
In this article, we take a closer look at bladder cancer screening tests, what they involve, and who should have them.
Bladder cancer screening tests are recommended for people who have had bladder cancer in the past or those who have an unusually high risk of bladder cancer. This includes people who have congenital bladder abnormalities and people with workplace exposure to certain chemicals used in the production of rubber, metals, and dyes.
Chemicals that increase the risk of bladder cancer include:
- aromatic hydrocarbons
- aromatic amines
Bladder cancer screening for people who aren’t at an increased risk or who haven’t had bladder cancer in the past isn’t currently recommended by any major health organization. This recommendation might change in the future if new tests are successfully developed.
Clinical trials are ongoing for bladder screening that could be effective for people who aren’t at high risk, don’t have a history of bladder cancer, and don’t have symptoms of bladder cancer.
There are three standard tests used to screen for bladder cancer. A doctor or healthcare professional will order the test, or tests, that are most appropriate for you.
- Urinalysis: A urinalysis test identifies substances, including blood, in the urine. Because blood in the urine is often one of the first symptoms of bladder cancer, a urinalysis test can find some early stage bladder cancers. However, blood in the urine has a range of noncancerous causes, so a urinalysis test can’t be used to confirm a diagnosis.
- Urine cytology: Urine cytology is a test that looks at a urine sample under a microscope to find cancer cells.
- Urine test for tumor markers: Tumor marker tests look for substances or cell changes produced by cancer. Bladder cancer tumor markers include the presence of mucin, carcinoembryonic antigen, and bladder tumor-associated antigen in the urine as well as chromosomal changes.
Tests to help identify bladder cancer in low risk populations are in development. Potential tests also look for tumor markers. For instance, a test to find a biomarker called uTERTPM has shown promise in clinical trials.
There are no standard recommendations for bladder cancer screening. Bladder cancer screening frequency depends on your individual risk.
A doctor will let you know if you need to be screened for bladder cancer. They’ll also explain how often you should be screened.
Although bladder cancer screening is safe and noninvasive, there are risks involved. The primary risk is the possibility of receiving a false positive. This means the test results indicate cancer when no cancer is present.
Typically, further testing will contradict the false-positive result and will prove bladder cancer is an incorrect diagnosis. However, the time between receiving a false positive and getting the results of further testing is often stressful and frightening for the person who received the false-positive result.
It’s also possible to receive a false-negative result. A false negative means that a screening test indicates no cancer is present in a person who does have cancer. A false-negative result can happen when screening misses and doesn’t find cancer. This can delay treatment.
Even when people have symptoms of bladder cancer, a false positive can cause them to assume their symptoms are caused by another condition.
What are the symptoms of bladder cancer?
Symptoms of bladder cancer include:
- blood in the urine
- pink, orange, or red urine
- pain or burning during urination
- increased urinary frequency
- increased urinary urgency
- getting up to urinate many times during the night
- having difficulty urinating
- one-sided lower back pain
- loss of appetite
- unintentional weight loss
- bone pain
- swelling in feet and hands
It’s important to keep in mind that many of these symptoms can be caused by conditions that aren’t bladder cancer. They’re a lot more likely to be caused by a condition such as a urinary tract infection than by bladder cancer.
However, it’s important to get any of these symptoms checked out by a doctor, especially if you’ve had them for more than a week or two.
Is there anything you can do to prevent bladder cancer from developing (or lower your risk)?
There’s no way to prevent bladder cancer, but you can take steps to lower your risk. This includes:
- Quitting smoking: Smoking increases your risk of many cancers, including bladder cancer.
- Reducing exposure to certain chemicals: Certain workplace chemicals can increase your risk of bladder cancer. Reducing your exposure can lower your risk. Modern workplaces are taking steps to protect their employees from exposure.
- Staying hydrated:
Evidencesuggests that drinking a lot of water could lower your risk of bladder cancer.
- Eating fruits and vegetables: Some
studieshave found that eating a lot of fruits and vegetables can lower your risk of bladder cancer. Although these results haven’t been confirmed by other studies, eating a healthy diet that’s high in fruits and vegetables is recommended by the American Cancer Society as a way to help lower your risk of all cancers.
How is bladder cancer treated?
Bladder cancer treatment options depend on factors such as the stage at diagnosis and your overall health. Common treatment options are discussed below.
- Surgery: Surgery is generally the first step in the treatment of bladder cancer, especially in the early stages. Sometimes the tumor can be removed without removing the bladder. In other cases, a doctor might recommend complete bladder removal.
- Chemotherapy: Chemotherapy is used to kill cancer cells. You might have chemotherapy before or after surgery.
- Radiation: Radiation can kill cancer cells and shrink tumors. Radiation is sometimes given before surgery to help shrink the tumor and make it easier to remove.
- Immunotherapy: Immunotherapy treatment helps your immune system respond to cancer. It might be an option if chemotherapy and radiation haven’t been effective or if bladder cancer has returned.
What’s the outlook for people with bladder cancer?
Your outlook for bladder cancer depends on factors such as stage at diagnosis, overall health, and response to treatment.
According to the American Cancer Society, the overall 5-year survival rate for bladder cancer was
It’s important to keep in mind that these numbers are based on data collected between 2011 and 2017. Cancer treatments have improved since then, and it’s likely that current survival rates are higher than these numbers suggest. Additionally, your individual outlook is influenced by your overall health, age, and other personal factors.
What is a 5-year survival rate?
Health professionals often use 5-year survival rate as a measure of the outlook for people with a disease. It refers to the percentage of people with the disease who are still alive at least 5 years after their diagnosis.
5-year relative survival rate is another commonly used term. This is a measure of how many people with the disease are alive 5 years later compared with people without the disease.
There’s currently no standard screening for bladder cancer. At this time, screening is only recommended for people who have a history of bladder cancer or those who are at very high risk of bladder cancer.
If you’re in this group, a doctor will order the most appropriate test for you and will let you know how often you should be screened.
Standard screening tests for people who are at low risk of bladder cancer are currently in development. Clinical trials are also ongoing.