Understanding Bladder Cancer

Last updated and reviewed on May 23, 2026. 

What is bladder cancer screening?

Screening means looking for a disease before it causes symptoms. Right now, no major health groups recommend screening for bladder cancer in people who are at average risk and have no symptoms. This is because the tests we have are not always accurate enough to be used on healthy people, and they can lead to extra tests that may cause stress or harm. However, screening may be useful for people at higher risk.

Types of bladder cancer screening tests

Several types of tests can be used to look for signs of bladder cancer. While none of these are currently used as routine screening for everyone, your doctor may use one or more of them if you are at higher risk or if you are being monitored after previous bladder cancer.

• Urinalysis and Urine Dipstick Test: This is a simple test that checks a urine sample for blood, protein, and other substances. A urine dipstick can detect blood in the urine, which might suggest the presence of bladder cancer. However, blood in the urine can also be caused by many other things, so a positive result requires further investigation.

• Urine Cytology: In this test, a sample of urine is examined under a microscope to look for cancer cells. If abnormal cells are found, further tests are needed. Urine cytology is best at detecting higher-grade cancers.

• Urine Biomarker Tests: These are newer tests that look for specific proteins or genetic materials in the urine that may be produced by cancer cells. Some of these tests have been approved by the FDA for use in monitoring people who have already been diagnosed with bladder cancer. Researchers are studying whether they could also be useful for screening people who have never had the disease.

• UroVysion: This test looks for chromosome changes that are often seen in bladder cancer cells.

• BTA tests: These tests look for a substance called bladder tumor antigen (BTA), also known as CFHrp, in the urine.

• ImmunoCyt: This test looks at cells in the urine for the presence of substances such as mucin and carcinoembryonic antigen (CEA), which are often found on cancer cells.

• NMP22 BladderChek: This test looks for the NMP22 protein in the urine. People who have bladder cancer often have higher levels of this protein.

• Cystoscopy: This is a procedure where a doctor uses a thin, flexible, lighted tube (called a cystoscope) to look directly inside the bladder. It is the most accurate way to check for bladder cancer, but it is more invasive than urine tests. It is commonly used in people who have had bladder cancer before to check for recurrence.

When should you start screening for bladder cancer?

Because there is no recommended routine screening program for bladder cancer in the general population, there is no set age at which everyone should start being screened. Instead, decisions about bladder cancer screening are based on your personal risk level.

For people who smoke or have smoked heavily, doctors may be more attentive to urinary symptoms and may recommend checking for blood in the urine more regularly. If you have worked for many years with industrial chemicals known to raise bladder cancer risk, you should discuss this history with your doctor so they can decide if monitoring is appropriate.

People who have already been diagnosed with bladder cancer and treated are closely monitored on a regular schedule, often with cystoscopy and urine tests every three to six months for the first few years after treatment, and less often after that. This is because bladder cancer has a high rate of recurrence, making follow-up care extremely important.

If you have a family history of bladder cancer or a condition like Lynch syndrome that is known to raise your risk, speaking with a genetic counselor and discussing appropriate monitoring with your doctor is a good idea. The earlier you have that conversation, the better prepared you will be to catch any signs of cancer early.

Which Screening Tests Should I Choose?

The right screening test for you depends on your individual risk factors, your medical history, and your doctor's recommendations. There is no single best test that works for everyone, and in many cases, a combination of tests provides the most reliable information.

For most people with no special risk factors and no symptoms, no routine bladder cancer screening test is currently recommended. However, your doctor will likely check your urine as part of regular health checkups. If blood is found in a routine urine test, further investigation is always needed, even if you feel fine.

For people with a history of bladder cancer, a combination of cystoscopy and urine cytology is typically used during follow-up visits. Your doctor will set up a schedule based on the stage and grade of your previous cancer.

For people at high risk who have not yet been diagnosed, newer urine biomarker tests may eventually play a role, but most of these are still being studied in research trials. Your doctor can tell you about any new options that may be available.

When choosing a screening approach, it is important to consider the benefits (finding cancer early) and the potential downsides (the discomfort of procedures, the possibility of false alarms that lead to more tests). Talking openly with your doctor about your concerns and personal risk factors is the best way to make a decision that is right for you.

Reducing your risk through lifestyle changes

While you cannot change your age, sex, or family history, there are several steps you can take to lower your risk of developing bladder cancer or reduce the chance that it will come back after treatment.

• Stop Smoking: This is the single most important thing you can do. Quitting smoking at any age reduces your exposure to cancer-causing chemicals and lowers your bladder cancer risk over time. If you currently smoke, talk to your doctor about resources to help you quit, including nicotine replacement therapy and prescription medicines.

• Avoid Harmful Chemical Exposures: If you work with industrial chemicals, use all recommended safety equipment, follow workplace safety guidelines, and talk to your employer about reducing exposure to known carcinogens. Make sure your drinking water is clean and free from arsenic, especially if you use a private well.

• Drink Plenty of Water: Staying well hydrated means that potentially harmful substances in your urine are more diluted and spend less time in contact with your bladder lining. Drinking six to eight glasses of water per day is a good general guideline.

• Eat a Healthy Diet: Research suggests that eating plenty of fruits and vegetables — especially cruciferous vegetables like broccoli and cabbage — may help protect against bladder cancer. Limiting processed meats and maintaining a healthy weight are also associated with lower cancer risk overall.

• Stay Physically Active: Regular exercise is good for your overall health and may help lower cancer risk. Survivors of bladder cancer are encouraged to stay active and avoid a sedentary lifestyle, as physical activity has been linked to better quality of life and possibly better outcomes.

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