What Increases My Chance of Developing Bladder Cancer?

Putting Out Your Cigarette Is Your Best Bet

breaking cigarette in half
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While bladder cancer is not 100 percent preventable, you may be surprised to learn there are some things you can do to lower your risk of developing it.

A great start is to stop smoking, as scientific research has consistently shown that cigarette smoking increases the chance that a person will develop bladder cancer. In fact, smoking cigarettes is the biggest risk factor for developing bladder cancer in western countries, accounting for about 50 percent of all cases.

That being said, not all risk factors (like smoking) are within your control. For instance, you cannot alter your genetic makeup and certain genes may make you more likely to get bladder cancer.

Another important point is that these factors (whether or not they are in your control) do not 100 percent predict your likelihood that you will get bladder cancer. In other words, just because you smoke or just because you have a family history of bladder cancer does not mean you will definitively get it. At the same time, your risk of developing bladder cancer is not zero percent just because you do not smoke or do not have a family history.

In the end, your risk of developing cancer—like the vast majority of cancers—stems from a complex interaction between your genes and your environment. Let's explore other factors that increase your chances of being diagnosed with bladder cancer, and what you can do to minimize those chances.

Cigarette Smoking

In an analysis of over 450,000 people, former cigarette smokers were two times more likely to develop bladder cancer than non-smokers, and current smokers were four-fold more likely to develop bladder cancer. People who smoke pipes or cigars were also found to be at a higher risk of developing bladder cancer, although the risk was smaller than in those who smoke cigarettes.

While this study supports the important role cigarette smoking plays in getting bladder cancer, it also suggests that stopping smoking can significantly decrease your risk, although not eliminate it.

How much and how long a person smokes also matters. According to a study in Urology, people who were heavy smokers had a higher-grade tumor (meaning the cancer cells looked very abnormal) at a more advanced stage (meaning the cancer had spread farther) at the time of diagnosis than those who never smoked or were light smokers. Heavy smoking was defined as 30 or more pack years and light smoking was defined as less than 30 pack years.

The precise mechanism that cigarette smoking plays in the development of bladder cancer development is still unclear. That being said, there are a number of carcinogens in tobacco (over 60) linked to bladder cancer.

Occupations

Exposure to certain chemicals, like aniline dyes and other types of aromatic amines, in a person's workplace may increase their risk of developing bladder cancer.

In fact, up to 10 percent of bladder cancers are caused by these chemical exposures. Examples of occupations linked to a higher risk of bladder cancer include:

  • textile, rubber, leather, metal, dye, petroleum, or chemical workers
  • people who work with printing materials
  • painters
  • hairdressers who work with dyes
  • dry cleaners
  • truck drivers (probably from being exposed to diesel fumes)
  • shoe polisher
  • drill press operator

Research suggests that the risk of developing bladder cancer holds for more than 30 years after the workplace exposure to these chemical carcinogens ends.

Chronic Bladder Inflammation

Certain health conditions, like recurrent or chronic untreated urinary tract infections, bladder stones, bladder dysfunction from nerve problems, and those with an indwelling urinary catheter, may develop chronic inflammation of the bladder. This can increase their risk of getting bladder cancer, especially a specific type of bladder cancer, called squamous cell carcinoma—although, overall this type only accounts for about 1 to 2 percent of all bladder cancers.

In addition, chronic and untreated infection with a parasite (found in contaminated fresh water sources) called Schistosoma haematobium is linked mostly to squamous cell carcinoma of the bladder.

Arsenic in Water

Arsenic found in drinking water has been associated with a higher risk of bladder cancer. Arsenic levels in drinking water are elevated in certain areas of the world, like parts of Taiwan, Japan, Bangladesh, and western South American.

Some rural parts of the western United States also have natural arsenic in the water. Most sources of water that contain higher arsenic levels come from wells. Be assured that for the majority of people in the United States, drinking water is not a major source of arsenic.

Certain Medications or Supplements

Taking the Chinese Herb Aristolochia fangchi is linked to both an increased risk of bladder cancer as well as other cancers in the urinary tract system.

Long term use of the diabetes medication thiazolidinediones has also been linked to bladder cancer, although the scientific data behind this is still mixed.

Water Intake

Some research suggests that people who urinate more (because they drink more fluids) have a lower risk of bladder cancer. Experts believe that the increased fluids may help clear out carcinogens in the bladder.

Factors Not Within Your Control

There are some factors that increase your risk of developing bladder cancer that simply cannot be changed. These include:

  • gender (bladder cancer is more common in men than women)
  • race (Caucasians are twice as likely to develop bladder cancer as African-Americans)
  • age (90 percent of those with bladder cancer are over the age of 55, according to the American Cancer Society)
  • certain birth defects of the bladder
  • personal history of bladder cancer—a new tumor can form in a different location within the bladder
  • personal history of another cancer in the urinary tract system (for example, kidney, ureter, or urethra)
  • a history of radiation therapy for pelvic cancer (for example, prostate, testicular, cervical, or ovarian cancer) 
  • history of taking a chemotherapy medication called Cytoxan (cyclophosphamide)
  • a family history of bladder cancer 

A family history of bladder cancer may or may not be related to a person's genetic makeup. For instance, certain genetic syndromes or mutations (which occur when cells in your body are dividing) are linked to getting bladder cancer, and whether you inherit this is out of your control. Research suggests that a younger age of onset for getting bladder cancer may be more likely to be inherited—although, this is not a hard and fast rule.

But a family history may be more within your control if your loved one develops bladder cancer because of an exposure, like to cigarette smoke or a chemical. In fact, secondhand smoke has been linked to an increased risk of bladder cancer in women (although interestingly, not men), according to a study in Cancer Research.

A Word From Verywell

When it comes to bladder cancer, there is no way to 100 percent prevent its development. That being said, you can be proactive in your bladder health by stopping smoking, drinking plenty of water, and limiting exposure to chemical carcinogens and/or practicing proper safety precautions when you have to be around them.

Whether or not eating a healthy diet rich in fruits and vegetables may also help prevent bladder cancer is still being teased out by experts. That being said, a nutritious and well-balanced diet has other health benefits like protecting your heart and preventing other cancers, if not bladder cancer too.

Sources:

American Cancer Society. (May 2016). Bladder Cancer Risk Factors. 

Freedman ND, Silverman DT, Hollenbeck AR, Schatzkin A, Abnet CC. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011;306(7):737-45.

Jiang X, Yuan JM, Skipper PL, Tannenbaum SR, Yu MC. Environmental tobacco smoke and bladder cancer risk in never smokers of Los Angeles County. Cancer Res. 2007;67(15):7540-5.

McNeil, B. (2011). First Steps—I've Been Diagnosed with Bladder Cancer. In Gonzalgo ML (Ed), Patient's Guide to Bladder Cancer (1-9). Massachusetts: Jones and Bartlett Publishers.

Pietzak EJ, Mucksavage P, Guzzo TJ, Malkowicz SB. Heavy cigarette smoking and aggressive bladder cancer at initial presentation. Urology. 2015;86(5):968-72.

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