Bladder cancer is the most common cancer affecting the genitourinary system, with urothelial (transitional) cell cancers accounting for 90% of bladder carcinomas in the United States and Europe. Other histologic types of bladder cancer include squamous cell carcinoma, adenocarcinomas, and small cell neuroendocrine carcinomas.

Risk factors for development of bladder carcinoma include advancing age, male sex, being of Northern European descent, and cigarette smoking. Occupations with exposures linked to increased risk of bladder cancer include metal workers, painters, leather workers, miners, excavating-machine operators, and manufacturers of carpets, paints, plastics, and industrial chemicals.

Patients with bladder cancer typically present with painless gross or microscopic hematuria, although dysuria, frequency, and urgency may be the presenting symptoms. Diagnosis may be delayed due to the similarity of these symptoms to benign conditions such as urinary tract infections, nephrolithiasis, cystitis, or prostatitis. Urothelial cancer may mimic bladder cancer. In patients younger than 50 years, asymptomatic microscopic hematuria is rarely associated with bladder cancer.

Treatment options depend on depth of tumor invasion and presence or absence of metastatic disease. Transurethral resection of bladder tumor (TURBT) may be combined with adjuvant chemotherapy for early-stage disease with radical cystectomy and/or chemotherapy in late-stage disease.