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

This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.

Bladder and Other Urothelial Cancers Screening

What is screening?

Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread.

Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.

It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms.

If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.

General Information About Bladder and Other Urothelial Cancers

Bladder and other urothelial cancers are diseases in which malignant (cancer) cells form in the urothelium.

The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscle wall that allows it to get larger or smaller. The bladder holds urine until it is passed out of the body. Urine is the liquid waste that is made by the kidneys as they clean the blood. The urine passes from the two kidneys into the bladder through two tubes called ureters. When the bladder is emptied during urination, the urine goes from the bladder to the outside of the body through another tube called the urethra.

The urothelium is a layer of tissue that lines the urethra, bladder, ureters, prostate, and renal pelvis. Cancer that begins in the urothelium of the bladder is much more common than cancer that begins in the urothelium of the urethra, ureters, prostate, or renal pelvis. Because it is the most common form of urothelial cancer, bladder cancer is the focus of this summary.

There are 3 types of cancer that begin in the urothelial cells of the bladder. These cancers are named for the type of cells that become malignant (cancerous):

  • Transitional cell carcinoma: Cancer that begins in cells in the innermost layer of the bladder urothelium. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells.
  • Squamous cell carcinoma: Cancer that forms in squamous cells, which are thin, flat cells that may form in the bladder urothelium after long-term infection or irritation.
  • Adenocarcinoma: Cancer that begins in glandular (secretory) cells. Glandular cells in the bladder urothelium make substances such as mucus.

See the following PDQ summaries for more information about bladder and other urothelial cancers:

  • Bladder Cancer
  • Transitional Cell Cancer of the Renal Pelvis and Ureter

The risk of bladder cancer increases with age.

In the United States, bladder cancer occurs more often in men than in women, and more often in whites than in blacks. As the U.S. population has gotten older, the number of people diagnosed with bladder cancer has increased, but the number of deaths from bladder cancer has decreased. This is true for men and women of all races over the last 30 years. However, blacks and women with bladder cancer are more likely to die from the disease than white men with bladder cancer are.

Smoking can affect the risk of bladder cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for bladder cancer. Risk factors for bladder cancer include:

  • Using tobacco, especially smoking cigarettes.
  • Being exposed to certain substances, such as soot from coal, or chemicals used to make rubber, certain dyes, or textiles.
  • Working as a dry cleaner or in places where paper, rope, twine, or clothing is made.
  • Taking Aristolochia fangchi, a Chinese herb.
  • Drinking water that has high levels of arsenic.
  • Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium.
  • Using urinary catheters for a long time.
  • Having a history of kidney or bladder stones.
  • Past treatment with certain anticancer drugs or radiation therapy to the pelvis.
  • Having a kidney transplant.
  • Having hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome).

Screening for Bladder and Other Urothelial Cancers

Tests are used to screen for different types of cancer.

Some screening tests are used because they have been shown to be helpful both in finding cancers early and in decreasing the chance of dying from these cancers. Other tests are used because they have been shown to find cancer in some people; however, it has not been proven in clinical trials that use of these tests will decrease the risk of dying from cancer.

Scientists study screening tests to find those with the fewest risks and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) decreases a person's chance of dying from the disease. For some types of cancer, finding and treating the disease at an early stage may result in a better chance of recovery.

There is no standard or routine screening test for bladder cancer.

Screening for bladder cancer is under study and there are screening clinical trials taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site.

Two tests may be used to screen for bladder cancer in patients who have had bladder cancer in the past:

Cystoscopy

Cystoscopy is a procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope (a thin, lighted tube) is inserted through the urethra into the bladder. Tissue samples may be taken for biopsy.
Cystoscopy; drawing shows a side view of the lower pelvis containing the bladder, uterus, and rectum. Also shown are the vagina and anus. The flexible tube of a cystoscope (a thin, tube-like instrument with a light and a lens for viewing) is shown passing through the urethra and into the bladder. Fluid is used to fill the bladder. An inset shows a woman lying on an examination table with her knees bent and legs apart. She is covered by a drape. The doctor looks at an image of the inner wall of the bladder on a computer monitor.
Cystoscopy. A cystoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the urethra into the bladder. Fluid is used to fill the bladder. The doctor looks at an image of the inner wall of the bladder on a computer monitor.

Urine cytology

Urine cytology is the examination of urine under a microscope to check for abnormal cells.

Hematuria tests may also be used to screen for bladder cancer.

Hematuria (red blood cells in the urine) may be caused by cancer or by other conditions. A hematuria test is used to check for blood in a sample of urine by viewing it under a microscope or using a special test strip. The test may be repeated over time.

Risks of Screening for Bladder and Other Urothelial Cancers

Screening tests have risks.

Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.

False-positive test results can occur.

Screening test results may appear to be abnormal even though no cancer is present. A false-positive test result (one that shows there is cancer when there really isn't) can cause anxiety and is usually followed by more tests (such as cystoscopy or other invasive procedures), which also have risks. False-positive results often occur with hematuria testing; blood in the urine is usually caused by conditions other than cancer.

False-negative test results can occur.

Screening test results may appear to be normal even though bladder cancer is present. A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.

Your doctor can advise you about your risk for bladder cancer and your need for screening tests.

Changes to This Summary (08 / 10 / 2012)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

Editorial changes were made to this summary.

Questions or Comments About This Summary

If you have questions or comments about this summary, please send them to Cancer.gov through the Web site's Contact Form. We can respond only to email messages written in English.

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About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

Images in the PDQ summaries are used with permission of the author(s), artist, and/or publisher for use within the PDQ summaries only. Permission to use images outside the context of PDQ information must be obtained from the owner(s) and cannot be granted by the National Cancer Institute. Information about using the illustrations in the PDQ summaries, along with many other cancer-related images, are available in Visuals Online, a collection of over 2,000 scientific images.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

A clinical trial is a study to answer a scientific question, such as whether a method of finding cancer earlier can help people to live longer. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients and those who are at risk for cancer. During screening clinical trials, information is collected about the effects of a new screening method and how well it works. If a clinical trial shows that a new method is better than one currently being used, the new method may become "standard." People who are at high risk for a certain type of cancer may want to think about taking part in a clinical trial.

Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

Last Revised: 2012-08-10


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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