Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Bladder Cancer Health Center

Font Size

Bladder and Other Urothelial Cancers Screening (PDQ®): Screening - Health Professional Information [NCI] - Description of the Evidence


Additional risk factors associated with more aggressive forms of bladder cancer include neuropathic bladder and associated indwelling catheters;[25,26]Schistosoma haematobium bladder infections (Bilharzial bladder cancer);[27] exposure to the cancer chemotherapy agent cyclophosphamide [28,29] and perhaps other alkylating agents, such as ifosfamide (although the use of mesna in conjunction with these agents may reduce the incidence);[28] and pelvic radiation therapy for other malignancies, such as prostate cancer,[30,31] uterine cancer,[32] and cervical cancer.[33]

Specific genetic mutations associated with bladder cancer include the following:[34,35,36]

  • HRAS mutation (Costello syndrome or Faciocutaneoskeletal syndrome).
  • RB1 mutation.
  • PTEN/MMAC1 mutation (Cowden syndrome).
  • NAT2 slow acetylator phenotype.
  • GSTM1 null phenotype.

Urothelial tumors other than TCC include adenocarcinoma, SCC, and metastatic adenocarcinoma. Risks for squamous cell tumors in the bladder include indwelling catheters [37,38] and S. haematobium cystitis.

Adenocarcinomas account for less than 2% of primary bladder cancers, including metastases from the rectum, stomach, endometrium, breast, prostate, and ovary.[4]


Although occasional familial clusters have been anecdotally reported [39,40,41] and bladder cancer (as well as upper urinary tract TCC) is part of the Lynch family cancer syndrome II,[42] there is no evidence that tendencies towards developing bladder cancer are inherited.[43]

Clinical Presentation

Seventy percent of patients with bladder cancer have superficial disease at presentation.[44] Hematuria is the most common presenting sign, occurring in about 90% of cases. Hematuria may be intermittent, so a urinalysis without red blood cells does not exclude a diagnosis of urothelial cancer. In patients with macroscopic hematuria, the reported rates of bladder cancer range from 13% to 34.5%.[45,46,47] Other presenting symptoms include dysuria, urinary frequency or urgency, and less commonly, flank pain secondary to obstruction, and pain from pelvic invasion or bone metastases. Diagnosis and staging usually begin with cystoscopy. Full evaluation of the upper and lower urinary tract is required.[48]


More than 90% of bladder cancers diagnosed in the United States are pure TCCs or TCCs mixed with other histologies, primarily SCC, adenocarcinoma, or both. An additional 3% to 4% are pure SCCs, which are approximately twice as likely to occur in women as in men. SCCs also represent a greater proportion of bladder cancers occurring in individuals who have S. haematobium infections of the bladder or who have histories of long-term indwelling urinary catheters, bladder stones, or recurrent bladder infections.[29,37,38]

Next Article:

Bladder and Other Urothelial Cancers Screening (PDQ®): Screening - Health Professional Information [NCI] Topics

Today on WebMD

bladder cancer x-ray
Do you know the warning signs?
man with a doctor
Our health check will steer you in the right direction.
sauteed cherry tomatoes
Fight cancer one plate at a time.
Lung cancer xray
See it in pictures, plus read the facts.
Lifestyle Tips for Depression Slideshow
Bladder Sparing Cancer Treatment
Vitamin D
Pets Improve Your Health