Greater Boston Urology Blog

Risk Factors and Prevention Strategies for Bladder Cancer

In honor of Bladder Cancer Awareness Month, we've asked one of our nurse practitioners, Urline Gregoire from our North Easton Care Center, to answer common questions about bladder cancer risk factors and prevention strategies.

As with all content on our blog, the following is educational, not medical advice. Always consult your medical provider regarding your healthcare needs.

First, briefly talk about what bladder cancer is.

URLINE: The bladder is a hollow muscular organ in the lower abdomen that stores urine. Bladder cancer occurs when bladder cells start to grow uncontrollably. As more cancer cells develop, they form a tumor, which can sometimes spread to other parts of the body.

There are different types of bladder cancer. The first and most common type is urothelial carcinoma, which starts in the urothelial cells lining the inside of the bladder.

Other types of bladder cancers include the following:

  • Squamous cell carcinoma is most common in Africa and the Middle East but rare in the United States.
  • Adenocarcinoma starts in gland-forming cells. Only 1% of bladder cancers are adenocarcinoma.
  • Small cell carcinoma starts in nerve-like cells called neuroendocrine cells; only 1% of bladder cancers are small cell carcinoma.
  • Sarcoma starts in the muscle cells of the bladder and is rare.

The American Cancer Society predicts around 83,190 new bladder cancer cases and 16,840 deaths in the U.S. in 2024. The good news? Recent trends show a decline in both new cases and death rates.

Let's talk about risk factors for bladder cancer, specifically the ones people can't change.

URLINE: Certain bladder cancer risks cannot be changed. The American Cancer Society's website provides more detail, but I'll provide an overview below.

Race and ethnicity. White people are about twice as likely to develop bladder cancer as African Americans. Asian Americans and American Indians have slightly lower rates of bladder cancer.

  • Age. Most people with bladder cancer are older (approximately nine out of 10 people diagnosed with the disease are over 55).
  • Biological sex: Bladder cancer is much more common in men than in women.
  • Genetics and family history. People who have a family history of bladder cancer have a higher risk of developing bladder cancer as well.
  • Bladder birth defects and chronic bladder irritation and infection. The latter has been linked to bladder cancer, but whether it causes bladder cancer remains unclear.


Now, let's talk about risk factors for bladder cancer that people have some control over.

URLINE: Smoking is one of the most significant risk factors. According to the American Cancer Society, people who smoke are three times as likely to develop bladder cancer.

Workplace exposure to certain chemicals can also increase a person's risk. For example, benzidine and beta-naphthylamine can increase a person's risk. These chemicals are sometimes used in the dye industry. (Learn about more industries here.)

Certain medicines and herbal supplements can also be problematic. The U.S. Food and Drug Administration (FDA) released a safety communication in 2016 stating "that use of type 2 diabetes medicine pioglitazone may be linked to an increased risk of bladder cancer."

The American Cancer Society reports that dietary supplements containing aristolochic acid have been linked with an increased risk of urothelial cancer and other cancers.

Lastly, not drinking enough water has been linked to a risk of developing bladder cancer. People who consume adequate amounts of water each day tend to have a lower bladder cancer rate than those who don't consume enough H20.

What role can diet play in preventing bladder cancer? Are there certain foods you recommend? What should people avoid?

URLINE: No official diet has been recommended to prevent bladder cancer. However, in 2019, the NIH reviewed 13 studies and found "evidence that adherence to the Mediterranean diet was associated with reduced risk of developing bladder cancer, suggesting a positive effect of the diet as a whole and not just one component."

This diet is nutrient-dense and filled with vegetables, fruits, legumes, whole grains, and healthy fats from fish, nuts, seeds, and olive oil.

In general, I recommend this sort of diet to patients. I also recommend limiting or avoiding highly processed foods, red meat, sugary foods, alcohol, and refined grains, such as white bread and pasta.

Is there anything else that you'd like to convey?

URLINE: Smoking cessation and staying well hydrated are the two main components of lowering one's risk of developing bladder cancer. So I always tell my patients that the best two things they can do to help lower their risk are to drink lots of water and quit smoking,

More articles from our site about bladder cancer:

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