What causes bladder cancer?

Updated: Nov 27, 2016
  • Author: Michael Christopher Large, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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See the list below:

  • Tobacco use accounts for up to 50% of all bladder cancer cases; people who smoke heavily quintuple their risk. Former smokers are at less of a risk for the disease than active smokers. The risk associated with second-hand smoke is unclear.

  • Exposure to aromatic amines found in some dyes, paints, solvents, leather dust, inks, combustion products, rubbers, and textiles is a risk factor.

  • Prior radiation therapy is a risk factor. Women who have undergone pelvic radiation (eg, for cervical cancer) have a 2- to 4-fold increased incidence rate; survival rates are poorer in men who have undergone radiation for prostate cancer than in men of similar age and stage who have not undergone radiation. [4]

  • Treatment with cyclophosphamide (Cytoxan, Neosar) and ifosfamide (Ifex) may lead to the development of bladder cancer through their metabolite acrolein. Following high-dose cyclophosphamide treatment, the 12-year prevalence of bladder cancer is as high as 11%.

  • Low daily fluid intake may be a contributing factor; the relative risk in persons who drink 6 cups of water per day is 0.49 compared with that in persons who drink one cup of water per day.

  • Schistosomiasis caused by the parasite S haematobium can cause SCC; this is common in Egypt and the Nile River Valley.

  • Long-term phenacetin use is a risk factor; this agent is no longer approved for use in the United States.

  • Long-term placement of indwelling catheters is a risk factor; patients who have indwelling catheters for longer than 10 years should undergo bladder surveillance via cytology and cystoscopy.

  • Artificial sweeteners (saccharin, cyclamate), when administered in high doses to laboratory animals, are risk factors for bladder cancer; no similar evidence has been shown in humans.

  • The use of Aristolochia fangchi, a Chinese herb, has been implicated as a risk factor for both upper and lower tract TCC.

  • Coffee and tea are not risk factors for bladder cancer.

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