There are 10,000 new cases each year with 75% of them occurring in men.
There is a clear association with certain occupations. These include those working in the rubber industry, working with aniline dyes, printing of textiles, and laboratory workers looking after rodents.
Smokers have a four times increased risk of bladder cancer compared to non smokers.
Drugs such as the overuse of the painkiller phenacetin has been associated with an increased risk. Those who have been treated with the chemotherapy drug cyclophosphamide in high doses are also at increased risk.
There are no obvious genes associated with an increased heritable risk.
Symptoms and signs
The commonest presenting sign is blood in the urine which is usually painless. Some cases are picked up when urine is tested on routine examination and found to contain microscopic amounts of blood. Occasionally it may present with pain on urination.
This will depend on the spread of the tumour at diagnosis. Superficial tumours can be treated locally by surgery or instillation of BCG into the bladder which is a bacteria used to vaccinate children against TB. Other chemo therapy agents can also be used.
If the tumour has spread further from the superficial layer of the bladder, then the choice of treatment is either surgical removal of the bladder or radiotherapy to the bladder.
If the bladder is removed, then the two surgical options are either to collect the urine in a bag which is attached to the surface of the abdomen or form a new bladder from a section of the bowel.