Bladder cancer risk factors

42% (44% in males and 37% in females) of bladder cancer cases each year in the UK are linked to major lifestyle and other risk factors[1]

Bladder cancer risk is associated with a number of risk factors[2,3].

Bladder Cancer Risk Factors

Increases risk ('sufficient' or 'convincing' evidence) May increase risk ('limited' or 'probable' evidence) Decreases risk ('sufficient' or 'convincing' evidence) May decrease risk ('limited' or 'probable' evidence)
  • Aluminium production
  • 4-Aminobiphenyl
  • Arsenic and inorganic arsenic compoundsa
  • Auramine production
  • Benzidine
  • Chlornaphazine
  • Cyclophosphamide
  • Magenta production
  • 2-Naphthylamine
  • Painting
  • Rubber production industry
  • Schistosoma haematobium
  • Tobacco smoking
  • ortho-Toluidine
  • X-radiation, gamma-radiation
  • 4-Chloro-ortho-toluidine
  • Coal-tar pitch
  • Coffee
  • Dry cleaning
  • Engine exhaust, diesel
  • Hairdressers and barbers (occupational exposure)
  • Pioglitazone
  • Printing processes
  • Soot
  • Textile manufacturing
  • Tetrachloroethylene
   

International Agency for Research on Cancer (IARC) and The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classifications. Find out more about IARC and WCRF/AICR classifications.

a Arsenic in drinking water is classified by WCRF/AICR as a possible cause of bladder cancer based on limited-suggestive evidence

References

  1. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 2011;105(S2):S77-S81.
  2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  3. World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007.
Last reviewed:

Tobacco smoking is classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer.[1] An estimated 37% of bladder cancers in the UK are linked to tobacco smoking.[2]

Bladder cancer risk is 3.8 times higher in current smokers compared with never-smokers, a meta-analysis of cohort studies showed.[3] Bladder cancer risk increases with amount and duration of smoking, a meta-analysis and pooled analyses of case-control studies have shown.[4-6]

Bladder cancer risk is 73-80% lower in ex-smokers who quit 25 years previously, compared with ongoing smokers, pooled analyses have shown; however, ex-smokers risk remains higher than never-smokers risk.[5,6]

Higher bladder cancer risk in smokers may partly reflect mutual confounding by occupational exposures.[7]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 2011;105(S2):S77-S81.
  3. Freedman ND, Silverman DT, Hollenbeck AR, et al. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011 Aug 17;306(7):737-45.
  4. Hemelt M, Yamamoto H, Cheng KK, Zeegers MP. The effect of smoking on the male excess of bladder cancer: a meta-analysis and geographical analyses. Int J Cancer. 2009 Jan 15;124(2):412-9.
  5. Brennan P, Bogillot O, Cordier S, et al. Cigarette smoking and bladder cancer in men: a pooled analysis of 11 case-control studies. Int J Cancer. 2000 Apr 15;86(2):289-94.
  6. Brennan P, Bogillot O, Greiser E, et al. The contribution of cigarette smoking to bladder cancer in women (pooled European data). Cancer Causes Control. 2001 Jun;12(5):411-7.
  7. 't Mannetje A, Kogevinas M, Chang-Claude J, et al. Smoking as a confounder in case-control studies of occupational bladder cancer in women. Am J Ind Med. 1999 Jul;36(1):75-82.
Last reviewed:

There are occupational exposures are classified by The International Agency for Research on Cancer (IARC) as causes of bladder cancer.[1] An estimated 5-6% of bladder cancers in the UK are linked to occupational exposures.[2,3]

Higher bladder cancer risk in certain occupations may partly reflect mutual confounding by smoking.[4]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 2011;105(S2):S77-S81.
  3. Brown T, Slack R, Rushton L; British Occupational Cancer Burden Study Group. Occupational cancer in Britain. Urinary tract cancers: bladder and kidney. Br J Cancer. 2012 Jun 19;107 Suppl 1:S76-84.
  4. 't Mannetje A, Kogevinas M, Chang-Claude J, et al. Smoking as a confounder in case-control studies of occupational bladder cancer in women. Am J Ind Med. 1999 Jul;36(1):75-82.
Last reviewed:

Aromatic amines are used in production of dyes, rubber, and textiles; they are also found in pesticides.[1]

Working in production of auramine or magenta dyes, and exposure to 4-Aminobiphenyl, benzidine, 2-Naphthylamine, or ortho-Toluidine (chemicals used in dye production), are classified by The International Agency for Research on Cancer (IARC) as causes of bladder cancer; 4-Chloro-ortho-toluidine is classified as a probable cause.[2] Working in rubber production is classified by IARC as a cause of bladder cancer.[2] Working as a hairdresser/barber, printer, or textile manufacturer (occupations which may involve aromatic amine exposure) is classified by IARC as a probable cause of bladder cancer, based on limited evidence.[2]

An estimated 1% of bladder cancers in males and females in Britain are linked to aromatic amines.[1] An estimated 0.1% of bladder cancers in males and 0.3% in females in Britain are linked to working as a hairdresser/barber.[1]

Bladder cancer risk is 29% higher in rubber workers compared with the general population, a meta-analysis showed.[3]

Bladder cancer risk is 30-35% higher in hairdressers compared with the general public, meta-analyses have shown; however it remains unclear whether this is limited to hairdressers working before some carcinogenic chemicals were banned from hair dyes in the 1970s.[4,5] This is distinct from domestic personal hair dye use.

Bladder cancer risk is 27% higher in leather workers compared with the general population, a meta-analysis showed.[3]

References

  1. Brown T, Slack R, Rushton L; British Occupational Cancer Burden Study Group. Occupational cancer in Britain. Urinary tract cancers: bladder and kidney. Br J Cancer. 2012 Jun 19;107 Suppl 1:S76-84.
  2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  3. Reulen RC, Kellen E, Buntinx F, et al. A meta-analysis on the association between bladder cancer and occupation. Scand J Urol Nephrol Suppl. 2008 Sep;(218):64-78.
  4. Harling M, Schablon A, Schedlbauer G, et al. Bladder cancer among hairdressers: a meta- analysis. Occup Environ Med. 2010 May;67(5):351-8.
  5. Takkouche B, Regueira-Méndez C, Montes-Martínez A. Risk of cancer among hairdressers and related workers: a meta-analysis. Int J Epidemiol. 2009 Dec;38(6):1512-31.
Last reviewed:

Polycyclic aromatic hydrocarbons (PAHs) are formed during combustion of fossil and carbon-containing fuels such as wood, coal, diesel, and fat.[1]

Working in aluminium production (which involves PAH exposure) is classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer.[2] Occupational exposures to coal-tar pitch, soot, or diesel engine exhaust are classified by IARC as probable causes of bladder cancer, based on limited evidence.[2]

An estimated 0.1% of bladder cancers in males and 0.04% in females in Britain are linked to PAHs.[1] An estimated 1% of bladder cancers in males and 0.2% in females in Britain are linked to diesel engine exhaust.[1]

Bladder cancer risk is not associated with working in aluminium or iron and steel production, a meta-analysis showed; however there was a suggestion of increased risk.[3]

Bladder cancer risk is 8% higher among professional drivers and railroad workers, a meta-analysis of cohort studies showed.[4] Case-control studies indicate a higher risk increase, but also that this risk increase has lessened over time.[4,5]

Bladder cancer risk is 31% higher in miners compared with the general population, a meta-analysis showed.[5]

Bladder cancer risk is 21-27% higher in mechanics compared with the general population, a meta-analysis showed.[5]

References

  1. Brown T, Slack R, Rushton L; British Occupational Cancer Burden Study Group. Occupational cancer in Britain. Urinary tract cancers: bladder and kidney. Br J Cancer. 2012 Jun 19;107 Suppl 1:S76-84.
  2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  3. Rota M Bosetti C, Boccia S, et al. Occupational exposures to polycyclic aromatic hydrocarbons and respiratory and urinary tract cancers: an updated systematic review and a meta-analysis to 2014. Arch Toxicol. 2014 Aug;88(8):1479-90.
  4. Manju L, George PS, Mathew A. Urinary bladder cancer risk among motor vehicle drivers: a meta-analysis of the evidence, 1977- 2008. Asian Pac J Cancer Prev. 2009 Apr-Jun;10(2):287-94.
  5. Reulen RC, Kellen E, Buntinx F, et al. A meta-analysis on the association between bladder cancer and occupation. Scand J Urol Nephrol Suppl. 2008 Sep;(218):64-78.
Last reviewed:

Working as a painter is classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer.[1]

An estimated 1% of bladder cancers in males and 0.1% in females in Britain are linked to working as a painter.[2]

Bladder cancer risk is 28% higher in painters compared with the general population, a meta-analysis showed.[3]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Brown T, Slack R, Rushton L; British Occupational Cancer Burden Study Group. Occupational cancer in Britain. Urinary tract cancers: bladder and kidney. Br J Cancer. 2012 Jun 19;107 Suppl 1:S76-84.
  3. Guha N, Steenland NK, Merletti F, et al. Bladder cancer risk in painters: a meta-analysis. Occup Environ Med 2010; 67(8):568-73.
Last reviewed:

Exposure to arsenic or inorganic arsenic compounds is classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer.[1] Arsenic in drinking water is classified by the World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR) as a possible cause of bladder cancer based on limited-suggestive evidence.[2]

Bladder cancer risk is higher in people with 10μg/L or higher arsenic concentration in their drinking water, a meta-analysis showed; risk increases with higher concentrations.[3] Bladder cancer risk is only increased with high-level, long-term arsenic exposure;[4] an interaction with tobacco use is possible.[5]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR, 2007.
  3. Saint-Jacques N, Parker L, Brown P, Dummer TJ. Arsenic in drinking water and urinary tract cancers: a systematic review of 30 years of epidemiological evidence. Environ Health. 2014 Jun 2;13:44.
  4. International Agency for Research on Cancer. Monographs on the evaluation of carcinogenic risks to humans, vol 100C. Arsenic and arsenic compounds Available from http://monographs.iarc.fr/ENG/Monographs/vol100C/. Accessed April 2014.
  5. Tsuji JS, Alexander DD, Perez V, Mink PJ. Arsenic exposure and bladder cancer: quantitative assessment of studies in human populations to detect risks at low doses. Toxicology. 2014 Mar 20;317:17-30.
Last reviewed:

Exposure to trichloroethylene (PCE) is classified by The International Agency for Research on Cancer (IARC) as a probable cause of bladder cancer, based on limited evidence.[1] PCE is used in dry cleaning fluid; working as a dry cleaner is also classified by IARC as a probable cause of bladder cancer.[1]

Bladder cancer risk is not associated with occupational PCE exposure, a meta-analysis showed.[2] Bladder cancer risk is probably not associated with working as a dry cleaner, a meta-analysis showed; smoking may explain any apparent link.[2]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Vlaanderen J, Straif K, Ruder A, et al. Tetrachloroethylene exposure and bladder cancer risk: a meta-analysis of dry-cleaning-worker studies. Environ Health Perspect. 2014 Jul;122(7):661-6.
Last reviewed:

Mineral oils are not specifically classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer, however aluminium production is classified as a cause of bladder cancer,[1] and this, along with other metalworking, may involve exposure to mineral oils.[2]

An estimated 4% of bladder cancers in males and 0.7% in females in Britain are linked to mineral oils.[2]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Brown T, Slack R, Rushton L; British Occupational Cancer Burden Study Group. Occupational cancer in Britain. Urinary tract cancers: bladder and kidney. Br J Cancer. 2012 Jun 19;107 Suppl 1:S76-84.
Last reviewed:

Bladder cancer risk is higher in survivors of larynx,[1] lung,[1],[2] head and neck,[1,2] prostate,[1-3] testicular,[4] cervical,[5] and kidney cancers,[1] cohort studies have shown.

Genitourinary cancer risk is 1.7-2.7 times higher in children and Tennage and Young Adults (TYAs) who had any type of cancer in childhood, compared with the general population, a cohort study showed.[6]

Bladder cancer risk is probably increased in cancer survivors due to the effects of radiotherapy or chemotherapy treatment, and shared risk factors with the first cancer, including smoking.

Last reviewed:

X radiation and gamma radiation are classified by The International Agency for Research on Cancer (IARC) as causes of bladder cancer.[1] An estimated 3% of bladder cancers in the UK are linked to ionising radiation, mainly diagnostic radiation.[2]

Bladder cancer risk is not associated with radioactive iodine treatment for previous thyroid cancer, a meta-analysis showed.[3]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Parkin DM, Boyd L, Walker LC. 16. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. Br J Cancer 2011;105(S2):S77-S81.
  3. Sawka AM, Thabane L, Parlea L, et al. Second primary malignancy risk after radioactive iodine treatment for thyroid cancer: a systematic review and meta-analysis. Thyroid. 2009 May;19(5):451-7.
Last reviewed:

Chlornaphazine (a Hodgkin lymphoma treatment used in the 1950s) is classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer.[1]

Cyclophosphamide is classified by IARC as a cause of bladder cancer.[1]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
Last reviewed:

Bladder cancer risk is higher in people with spinal cord injury, which may be due to indwelling urinary catheters, urinary tract infections or bladder calculi.[1] 1% of spinal cord injury patients with indwelling catheter develop bladder cancer, a meta-analysis showed.[2]

Last reviewed:

Bladder cancer risk in women is twice higher in systemic sclerosis patients compared with the general population, a meta-analysis showed.[1] Bladder cancer risk in men is not associated with systemic sclerosis.[1] The risk increase may be due to use of cyclophosphamide for systemic sclerosis treatment.[1]

Last reviewed:

Bladder cancer risk is twice higher in people with Crohn’s disease, versus the general population, a meta-analysis showed.[1]

Last reviewed:

Pioglitazone (a diabetes treatment) is classified by The International Agency for Research on Cancer (IARC) as a probable cause of bladder cancer, based on limited evidence.[1]

Bladder cancer risk is up to around a third higher in diabetics compared with non-diabetics, meta-analyses have shown.[2-6] This is mainly due to diabetes treatment, though treatment type often relates to diabetes stage, which may further confound findings.

Bladder cancer risk among diabetics is 20% higher in pioglitazone users versus non-users, meta-analyses of observational studies have shown; meta-analysis of randomised controlled trials (RCTs) indicates a stronger risk increase.[7-10]

Bladder cancer risk among diabetics is decreased or not associated with other diabetes medications.

Bladder cancer risk in men is 10% higher in those with metabolic syndrome (characterised by overweight/obesity, ineffective insulin use, diabetes and hypertension), versus those without the condition, a meta-analysis showed.[11] Bladder cancer risk in women is not associated with metabolic syndrome.[11]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Fang H, Yao B, Yan Y, et al. Diabetes mellitus increases the risk of bladder cancer: an updated meta-analysis of observational studies. Diabetes Technol Ther 2013;15(11):914-22.
  3. Zhu Z, Wang X, Shen Z, Lu Y, Zhong S, Xu C. Risk of bladder cancer in patients with diabetes mellitus: an updated meta-analysis of 36 observational studies. BMC Cancer 2013;13:310.
  4. Xu X, Wu J, Mao Y, et al. Diabetes mellitus and risk of bladder cancer: a meta-analysis of cohort studies. PLoS One 2013;8(3):e58079. doi: 10.1371/journal.pone.0058079.
  5. Zhu Z, Zhang X, Shen Z, et al. Diabetes mellitus and risk of bladder cancer: a meta-analysis of cohort studies. PLoS One 2013;8(2):e56662. doi: 10.1371/journal.pone.0056662.
  6. Starup-Linde J, Karlstad O, Eriksen SA, et al. CARING (CAncer Risk and INsulin analoGues): The Association of Diabetes Mellitus and Cancer Risk with Focus on Possible Determinants- a Systematic Review and a Meta-Analysis. Curr Drug Saf. 2013 Nov 7.
  7. Ferwana M, Firwana B, Hasan R, et al. Pioglitazone and risk of bladder cancer: a meta-analysis of controlled studies. Diabet Med 2013;30(9):1026-32.
  8. Bosetti C, Rosato V, Buniato D, et al. Cancer risk for patients using thiazolidinediones for type 2 diabetes: a meta-analysis. Oncologist 2013;18(2):148-56.
  9. Colmers IN, Bowker SL, Majumdar SR, Johnson JA. Use of thiazolidinediones and the risk of bladder cancer among people with type 2 diabetes: a meta-analysis. CMAJ 2012;184(12):E675-83.
  10. Turner RM, Kwok CS, Chen-Turner C, et al. Thiazolidinediones and associated risk of Bladder Cancer: a Systematic Review and Meta- analysis. Br J Clin Pharmacol. 2013 Dec 10.
  11. Esposito K, Chiodini P, Colao A, et al. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012 Nov;35(11):2402-11.
Last reviewed:

Bladder cancer risk is up to 2.8 times higher in people with Human papillomavirus infection, versus uninfected people, a meta-analysis showed.[1,2]

Last reviewed:

Schistosoma haematobium infection (schistosomiasis Open a glossary item) is classified by The International Agency for Research on Cancer (IARC) as a cause of bladder cancer.[1]

In Sub-Saharan Africa, Egypt, Sudan, and Yemen (schistosomiasis is essentially confined to less-developed world regions), at least 41-42% of people with bladder cancer have schistosomiasis.[2]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. de Martel C, Ferlay J, Franceschi S, et al. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. 2012 Jun;13(6):607-15.
Last reviewed:

Bladder cancer risk is 1.8 times higher in people with a first-degree relative (parent, sibling, child) with the disease, compared with the general population, a cohort study showed.[1] Shared smoking habits are thought to explain much of this association; bladder cancer risk is also higher in spouses of people with the disease, and people with a family history of other smoking-related cancers.[1,2]

References

  1. Frank C, Fallah M, Ji J, et al. The population impact of familial cancer, a major cause of cancer. Int J Cancer. 2014 Apr 15;134(8):1899-906.
  2. Hemminki K, Bermejo JL, Ji J, Kumar R. Familial bladder cancer and the related genes. Curr Opin Urol. 2011 Sep;21(5):386-92.
Last reviewed:

Coffee is classified by The International Agency for Research on Cancer (IARC) as a probable cause of bladder cancer, based on limited evidence.[1]

Bladder cancer risk is not associated with coffee intake, meta-analyses of cohort studies have shown;[2,3] though meta-analyses of case-control studies indicate a possible risk increase.[3,4]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 105*. Available from: http://monographs.iarc.fr/ENG/Classification/index.php. Accessed August 2014.
  2. Huang TB, Guo ZF, Zhang XL, et al. Coffee consumption and urologic cancer risk: a meta-analysis of cohort studies. Int Urol Nephrol. 2014 Aug;46(8):1481-93.
  3. Zhou Y, Tian C, Jia C. A dose-response meta-analysis of coffee consumption and bladder cancer. Prev Med. 2012 Jul;55(1):14-22.
  4. Sala M, Cordier S, Chang-Claude J, et al. Coffee consumption and bladder cancer in nonsmokers: a pooled analysis of case-control studies in European countries. Cancer Causes Control. 2000 Dec;11(10):925-31.
Last reviewed:

Bladder cancer risk in men may be higher in those who drink the most tap water, meta-analyses have shown.[1,2] Bladder cancer risk in women is not associated tap water intake.[1,2]

The association may reflect the effect of tap water chlorination.[1-3]

Last reviewed:

Bladder cancer risk is 9% higher in obese (body mass index [BMI] 30+) people compared with healthy-weight people, a meta-analysis showed.[1] However, the association may be limited to males, and residual confounding by smoking is probable, a cohort study showed.[2]

Last reviewed:

Milk is classified by The World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR) as possibly protective against bladder cancer, based on limited-suggestive evidence.[1]

Bladder cancer risk is not associated with milk intake in studies of European populations, meta-analyses have shown.[2-5]

Last reviewed:

Bladder cancer risk is lower in people with the highest versus lowest levels of the following factors, meta- and pooled analyses or systematic reviews have shown:

  • Physical activity – 15% lower risk for the most versus least physically active people.[1]
  • Giving birth – 27-31% lower risk in parous versus nulliparous women; effect stronger in never-smokers versus ever-smokers.[2,3]
  • Later menopause – 49% lower risk in oldest versus youngest age at menopause.[2]
  • Later menarche – 43% lower risk with menarche aged 15+ versus younger.[4]
  • Selenium (blood or toenail levels) – 39% lower risk.[5]
  • Vitamin D (blood levels) - 25% lower risk.[6]
  • Fruit intake (some evidence of variation by study design).[7,8]
  • Vegetable intake (some evidence of variation by study design).[8]
  • Parkinson’s disease – 14% lower risk in people with the condition versus those without (probably linked with lower smoking rates in people with Parkinson’s disease).[9]

References

  1. Keimling M, Behrens G, Schmid D, Jochem C, Leitzmann MF. The association between physical activity and bladder cancer: systematic review and meta-analysis. Br J Cancer. 2014;110(7):1862-70.
  2. Dietrich K, Demidenko E, Schned A, et al. Parity, early menopause and the incidence of bladder cancer in women: a case-control study and meta-analysis. Eur J Cancer. 2011 Mar;47(4):592-9.
  3. Davis-Dao CA, Henderson KD, Sullivan-Halley J, et al. Lower risk in parous women suggests that hormonal factors are important in bladder cancer etiology. Cancer Epidemiol Biomarkers Prev. 2011 Jun;20 (6):1156-70.
  4. Daugherty SE, Lacey JV Jr, Pfeiffer RM, et al. Reproductive factors and menopausal hormone therapy and bladder cancer risk in the NIH-AARP Diet and Health Study. Int J Cancer. 2013 Jul 15;133(2):462- 72.
  5. Amaral AF, Cantor KP, Silverman DT, Malats N. Selenium and bladder cancer risk: a meta- analysis. Cancer Epidemiol Biomarkers Prev. 2010 Sep;19(9):2407-15.
  6. Liao Y, huang JL, Qiu MX et al. Impact of serum vitamin D level on risk of bladder cancer: a systemic review and meta-analysis.Tumour Biol. 2014 Oct [Epub ahead of print]
  7. Liang S, Lv G, Chen W, et al. Citrus fruit intake and bladder cancer risk: a meta-analysis of observational studies. Int J Food Sci Nutr. 2014 Jun 16:1-6. [Epub ahead of print]
  8. Yao B, Yan Y, Ye X et al. Intake of fruit and vegetables and risk of bladder cancer: a dose-response meta-analysis of observational studies. Cancer Causes Control. 2014 25 (12):1645-58
  9. Ong EL, Goldacre R, Goldacre M. Differential risks of cancer types in people with Parkinson's disease: a national record-linkage study. Eur J Cancer. 2014 Sept 50 (14)2456-62
Last reviewed:

Bladder cancer risk is not associated with the following factors, meta- and pooled analyses or systematic reviews have shown:

  • Environmental tobacco smoke.[1]
  • Alcohol.[1]
  • Personal hair dye use.[2]
  • Waterpipe smoking.[3]

References

  1. Van Hemelrijck MJ, Michaud DS, Connolly GN, Kabir Z. Secondhand smoking, 4-aminobiphenyl, and bladder cancer: two meta-analyses. Cancer Epidemiol Biomarkers Prev. 2009 Apr;18(4):1312-20.
  2. Turati F, Pelucchi C, Galeone C, et al. Personal hair dye use and bladder cancer: a meta-analysis. Ann Epidemiol. 2014 Feb;24(2):151- 9.
  3. Akl EA, Gaddam S, Gunukula SK, et al. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol. 2010 Jun;39(3):834-57.
Last reviewed:

  • Systemic lupus erythematosus.[1]
  • Rosiglitazone (among diabetics).[2-4]
  • Metformin (among diabetics).[5,6]
  • Insulin (among diabetics), though some evidence of lower risk.[7,8]
  • Paracetamol.[9]
  • Aspirin.[9,10]
  • Non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) (some evidence of lower risk in non-smokers).[9,10]
  • Statins.[11]
  • Postmenopausal hormone replacement therapy (HRT) (some evidence of lower risk with combined oestrogen-progesterone HRT).[12-14]
  • Oral contraceptives.[12-14]

References

  1. Ni J, Qiu LJ, Hu LF, et al. Lung, liver, prostate, bladder malignancies risk in systemic lupus erythematosus: evidence from a meta-analysis. Lupus. 2014 Mar;23(3):284-92.
  2. Bosetti C, Rosato V, Buniato D, et al. Cancer risk for patients using thiazolidinediones for type 2 diabetes: a meta-analysis. Oncologist 2013;18(2):148-56.
  3. Colmers IN, Bowker SL, Majumdar SR, Johnson JA. Use of thiazolidinediones and the risk of bladder cancer among people with type 2 diabetes: a meta-analysis. CMAJ 2012;184(12):E675-83.
  4. Turner RM, Kwok CS, Chen-Turner C, et al. Thiazolidinediones and associated risk of Bladder Cancer: a Systematic Review and Meta- analysis. Br J Clin Pharmacol. 2013 Dec 10.
  5. Noto H, Goto A, Tsujimoto T, et al. Cancer risk in diabetic patients treated with metformin: a systematic review and meta-analysis. PLoS One. 2012;7(3):e33411.
  6. Franciosi M, Lucisano G, Lapice E, et al. Metformin therapy and risk of cancer in patients with type 2 diabetes: systematic review. PLoS One. 2013 Aug 2;8(8):e71583.
  7. Tang X, Yang L, He Z, et al. Insulin glargine and cancer risk in patients with diabetes: a meta-analysis. PLoS One. 2012;7 (12):e51814.
  8. Karlstad O, Starup-Linde J, Vestergaard P, et al. Use of insulin and insulin analogs and risk of cancer - systematic review and meta-analysis of observational studies. Curr Drug Saf. 2013 Nov;8(5):333- 48.
  9. Zhang H, Jiang D, Li X. Use of nonsteroidal anti-inflammatory drugs and bladder cancer risk: a meta-analysis of epidemiologic studies. PLoS One. 2013 Jul 19;8(7):e70008.
  10. Daugherty SE, Pfeiffer RM, Sigurdson AJ, et al. Nonsteroidal antiinflammatory drugs and bladder cancer: a pooled analysis. Am J Epidemiol. 2011 Apr 1;173(7):721-30.
  11. Zhang XL, Geng J, Zhang XP, et al. Statin use and risk of bladder cancer: a meta-analysis. Cancer Causes Control. 2013 Apr;24 (4):769-76.
  12. Dietrich K, Demidenko E, Schned A, et al. Parity, early menopause and the incidence of bladder cancer in women: a case-control study and meta-analysis. Eur J Cancer. 2011 Mar;47(4):592-9.
  13. Davis-Dao CA, Henderson KD, Sullivan-Halley J, et al. Lower risk in parous women suggests that hormonal factors are important in bladder cancer etiology. Cancer Epidemiol Biomarkers Prev. 2011 Jun;20 (6):1156-70.
  14. Daugherty SE, Lacey JV Jr, Pfeiffer RM, et al. Reproductive factors and menopausal hormone therapy and bladder cancer risk in the NIH-AARP Diet and Health Study. Int J Cancer. 2013 Jul 15;133(2):462- 72.
Last reviewed:

  • Total fluid intake (some evidence of risk decrease in Asian populations, and women[1]).[2]
  • Sweetened carbonated beverages.[3]
  • Dietary folate (some evidence of lower risk in case-control studies).[4]
  • Eggs.[5]
  • Tea (some evidence of lower risk).[2,6,7]
  • Cruciferous vegetables (some evidence of lower risk in case-control studies).[8]
  • Fish.[9]
  • Meat (red or processed).[10]
  • Vitamin A (some evidence of lower risk in case-control studies).[11]

References

  1. Zhou J, Kelsey KT, Giovannucci E, Michaud DS. Fluid intake and risk of bladder cancer in the Nurses' Health Studies. Int J Cancer. 2014 Sep 1;135(5):1229-37.
  2. Bai Y, Yuan H, Li J, et al. Relationship between bladder cancer and total fluid intake: a meta-analysis of epidemiological evidence. World J Surg Oncol. 2014 Jul 17;12:223.
  3. Boyle P, Koechlin A, Autier P. Sweetened carbonated beverage consumption and cancer risk: meta-analysis and review. Eur J Cancer Prev. 2014 Sep;23(5):481-90.
  4. He H, Shui B. Folate intake and risk of bladder cancer: a meta-analysis of epidemiological studies. Int J Food Sci Nutr. 2013 Dec 16.
  5. Li F, Zhou Y, Hu RT, et al. Egg consumption and risk of bladder cancer: a meta-analysis. Nutr Cancer. 2013;65(4):538- 46.
  6. Wang X, Lin YW, Wang S, et al. A meta-analysis of tea consumption and the risk of bladder cancer. Urol Int. 2013;90(1):10- 6.
  7. Qin J, Xie B, Mao Q, et al. Tea consumption and risk of bladder cancer: a meta-analysis. World J Surg Oncol. 2012 Aug 25;10:172.
  8. Liu B, Mao Q, Lin Y, The association of cruciferous vegetables intake and risk of bladder cancer: a meta-analysis. World J Urol. 2013 Feb;31(1):127-33.
  9. Li Z, Yu J, Miao Q, et al. The association of fish consumption with bladder cancer risk: a meta-analysis. World J Surg Oncol. 2011 Sep 19;9:107.
  10. Wang C, Jiang H. Meat intake and risk of bladder cancer: a meta-analysis. Med Oncol. 2012 Jun;29(2):848-55.
  11. Tang JE, Wang RJ, Zhong H, et al. Vitamin A and risk of bladder cancer: a meta-analysis of epidemiological studies. World J Surg Oncol. 2014 Apr 29;12:130.
Last reviewed:

Citation

You are welcome to reuse this Cancer Research UK statistics content for your own work.

Credit us as authors by referencing Cancer Research UK as the primary source. Suggested styles are:

Web content: Cancer Research UK, full URL of the page, Accessed [month] [year]. 

Publications: Cancer Research UK ([year of publication]), Name of publication, Cancer Research UK. 

Rate this page:

No votes yet
Thank you!
We've recently made some changes to the site, tell us what you think

Share this page