There are several types of cancer that can affect the bladder. It’s unusual for bladder cancer to run in families, but some types may have a hereditary link.

Having one or more immediate family members with bladder cancer doesn’t mean you’ll get this disease. Although genetics may play a role, other factors that affect your risk, such as lifestyle choices, are under your control.

Smoking triples your risk of developing bladder cancer. Half of all bladder cancer is linked to smoking.

Some people with bladder cancer have a rare mutation in the RB1 gene. This gene can cause retinoblastoma, an eye cancer. It may also increase bladder cancer risk. This gene mutation can be inherited.

Other hereditary and rare genetic syndromes may increase bladder cancer risk. One is Cowden syndrome, which causes multiple noncancerous growths called hamartomas. Another is Lynch syndrome, which is more closely associated with increased risk of colon cancer.

There are many potential risk factors for bladder cancer, including the following:

Bladder development birth defects: Two rare birth defects may increase risk. One is a remnant urachus. The urachus connects your belly button to your bladder before birth. It usually disappears before birth. In rare cases, part of it can remain and become cancerous.

The other is exstrophy, which occurs when the bladder and the abdominal wall in front of it fuse together during fetal development. That causes the bladder wall to be external and exposed. Even after surgical repair, this defect increases the risk of bladder cancer.

Prior cancer diagnosis: A personal history of bladder cancer increases your risk of getting the disease again. Having other types of cancer, such as cancer of the urinary tract, may also increase risk.

Infections: Chronic bladder or urinary tract infections may increase risk, including those caused by prolonged use of bladder catheters.

Parasites: An infection caused by a parasitic worm, called schistosomiasis, is a risk factor. However, this occurs very rarely in the United States.

Ethnicity: White people get bladder cancer at higher rates than Black people, Hispanics, and Asians.

Age: Bladder cancer risk increases with age. The average age of diagnosis is 73.

Gender: Men are three to four times more likely to get bladder cancer than women, although women who smoke may be at greater risk than men who don’t.

Heredity: Having a close family member with the disease may increase your risk, although hereditary bladder cancer is rare. Bladder cancer diagnoses may cluster in families exposed consistently to the same environmental triggers, such as cigarette smoke or arsenic in water. This is different from having a hereditary link.

Smoking: The association between cigarette smoking and bladder cancer is significant. Current smokers are at greater risk than former smokers, but the risk is higher for both groups than it is for people who’ve never smoked.

Chemical exposure: Exposure to toxins such as arsenic in contaminated drinking water increases risk. People working with textiles, dyes, paint, and printing products may be exposed to benzidine and other hazardous chemicals linked to bladder cancer. Significant exposure to diesel fumes may also be a factor.

Medication: Long-term use of prescription medications containing pioglitazone may increase risk. These include several medications used to treat type 2 diabetes:

  • pioglitazone (Actos)
  • metformin-pioglitazone (Actoplus Met, Actoplus Met XR)
  • glimepiride-pioglitazone (Duetact)

Another medication that may increase risk is the chemotherapy drug cyclophosphamide.

Poor fluid intake: People who don’t drink enough water may have increased risk, possibly due to toxin buildup within the bladder.

In the United States, approximately 2.4 percent of people are diagnosed with bladder cancer at some point during their lifetime.

There are several kinds of bladder cancer. The most common is urothelial carcinoma. This cancer begins in cells that line the inside of the bladder and accounts for 90 percent of all bladder cancers. Less common bladder cancers are squamous cell carcinoma and adenocarcinoma.

The most common early symptom of bladder cancer is blood in the urine, or hematuria. If you have bladder cancer, your urine may appear pink, bright red, or brown. The blood may be visible only when your urine is checked under a microscope.

Other early symptoms include:

  • back pain
  • pelvic pain
  • pain during urination
  • frequent need to urinate

Screening for bladder cancer isn’t recommended for people of average risk.

High-risk individuals should discuss regular screening with their doctor. You may be at an increased risk if you:

  • come into contact regularly with chemicals
  • were born with a bladder-related birth defect
  • have a personal history of bladder cancer
  • are a heavy smoker

Screening procedures

Your doctor can use a urinalysis to look for blood in your urine. You’ll need to provide a urine sample for this test. A urinalysis doesn’t provide a definitive bladder cancer diagnosis, but it may be used as a first step.

Other screening tests include:

  • Urine cytology: This test checks for cancer cells in the urine. It also requires a urine sample.
  • Cystoscopy: During this test, your doctor inserts a narrow tube with a lens into your urethra to see inside your bladder. It requires local anesthesia.
  • Transurethral resection of bladder tumor (TURBT): Forthis operation, your doctor uses a rigid cystoscope with a wire loop on its end to remove abnormal tissue or tumors from the bladder. The tissue is then sent to a lab for analysis. It requires either general anesthesia or regional anesthesia. This procedure may also be used to treat early stage bladder cancer.
  • Intravenous pyelogram: In this procedure, your doctor injects a dye into your veins. They then use X-rays to view your kidneys, bladder, and ureters.
  • CT scan: A CT scan provides detailed visual information about your bladder and urinary tract.

If you’re diagnosed with bladder cancer, you may need additional tests to determine the stage of your cancer. These include chest x-ray, bone scan, and MRI scan.

Learn more: Understanding the stages of bladder cancer »

The type of treatment you require depends on the stage and kind of bladder cancer you have, as well as your age and overall health. Treatment may include:

  • surgical tumor removal, with or without a portion of the bladder
  • immunotherapy
  • bladder removal surgery
  • chemotherapy
  • radiation

Bladder cancer can be successfully cured, especially when diagnosed and treated in its early stages. Your outlook depends on the stage and your overall health at diagnosis.

According to the American Cancer Society, the 5-year relative survival rate for stage 1 is 88 percent. That means your chance of surviving 5 years is 88 percent as high as someone without bladder cancer.

For stage 2, that number drops to 63 percent, and for stage 3, 46 percent. For stage 4, or metastatic bladder cancer, the 5-year survival rate is 15 percent.

It’s important to understand that these numbers are estimates and can’t predict your chance of survival. If you develop any of the symptoms listed, see your doctor right away so that you can be diagnosed and treated early if necessary.

The best way to avoid most types of bladder cancer is to stop smoking. It’s also important to protect yourself from toxins in your environment whenever possible. If you’re regularly exposed to hazardous chemicals at work, you should wear protective gear, such as gloves and a face mask.

If you’re concerned about a genetic link, talk to your family members. Ask them each for a detailed health history that includes lifestyle habits. Make sure to share this information with your doctor. If your doctor determines that your risk is high, ask them if you should have regular screening exams.