Global risks and prevention of bladder cancer
- Recent estimates by the Global Burden of Disease Study Cancer Collaborators, published in The Lancet, project that by 2050 the global cancer burden will grow dramatically. - The Republic
- Currently (given 2023), there are an estimated 18.5 million new cancer diagnoses per year (excluding non-melanoma skin cancers), and about 10.4 million deaths attributable to cancer. Projections indicate that by 2050, annual new diagnoses could rise to 30.5 million (a 61 percent increase) and deaths to 18.6 million (a 75 percent increase). - Health Daily
- Of particular note is the fact that about 42 percent of cancer deaths are attributable to modifiable risk factors (smoking, poor diet, high blood sugar, obesity, alcohol, etc.). - Health Daily
- Low- and middle-income countries (LMICs) are expected to bear the brunt: more than half of new diagnoses and about two-thirds of deaths. - The Republic
- In Italy, the oncology profile is influenced by an aging population and advances in diagnosis and treatment. According to the report "EU Country Cancer Profile: Italy 2025," Italy maintains age-standardized mortality rates below the European average, thanks to a progressive reduction (-15 percent between 2011 and 2021) in oncology deaths. - OECD
- A recent paper (2025) on "Cancer incidence, mortality, and survival estimates in Italy" describes current patterns and trends in the peninsula, suggesting that cancer incidence in the country may increase in the coming years, driven by aging, better diagnoses, and changes in lifestyles. - ScienceDirect
- Currently (given 2023), there are an estimated 18.5 million new cancer diagnoses per year (excluding non-melanoma skin cancers), and about 10.4 million deaths attributable to cancer. Projections indicate that by 2050, annual new diagnoses could rise to 30.5 million (a 61 percent increase) and deaths to 18.6 million (a 75 percent increase). - Health Daily
- Of particular note is the fact that about 42 percent of cancer deaths are attributable to modifiable risk factors (smoking, poor diet, high blood sugar, obesity, alcohol, etc.). - Health Daily
- Low- and middle-income countries (LMICs) are expected to bear the brunt: more than half of new diagnoses and about two-thirds of deaths. - The Republic
- In Italy, the oncology profile is influenced by an aging population and advances in diagnosis and treatment. According to the report "EU Country Cancer Profile: Italy 2025," Italy maintains age-standardized mortality rates below the European average, thanks to a progressive reduction (-15 percent between 2011 and 2021) in oncology deaths. - OECD
- A recent paper (2025) on "Cancer incidence, mortality, and survival estimates in Italy" describes current patterns and trends in the peninsula, suggesting that cancer incidence in the country may increase in the coming years, driven by aging, better diagnoses, and changes in lifestyles. - ScienceDirect
Bladder cancer: importance, numbers and peculiarities
Bladder cancer is one of the most frequent urothelial malignancies. Data collected from international sources allow it to be placed in a global context: How prevalent is it?
- Worldwide: more than 614,000 new cases in 2022.
- In Italy: about 34,500 new cases per year.
- It affects mostly men (4 out of 5 cases).
- It is the 4th most frequent cancer among men in Italy.
- Worldwide: more than 614,000 new cases in 2022.
- In Italy: about 34,500 new cases per year.
- It affects mostly men (4 out of 5 cases).
- It is the 4th most frequent cancer among men in Italy.
Main risk factors
Bladder cancer is a prime example of how environmental and lifestyle factors affect cancer occurrence. Among the main ones are:
- Cigarette smoking → most important cause (risk is up to 4 times higher in smokers).
- Occupational exposure to chemicals (textiles, rubber, dyes, chemicals).
- Water contaminated with arsenic.
- Previous radiation therapy in the pelvic area.
- Genetic and molecular factors that promote tumor progression.
- Cigarette smoking → most important cause (risk is up to 4 times higher in smokers).
- Occupational exposure to chemicals (textiles, rubber, dyes, chemicals).
- Water contaminated with arsenic.
- Previous radiation therapy in the pelvic area.
- Genetic and molecular factors that promote tumor progression.
Diagnosis and staging
The diagnosis of bladder cancer typically relies on:
- Macroscopic hematuria: presence of visible blood in the urine is often the warning sign.
- Urinary cytology: examination of urine to identify free neoplastic cells (Urine24 provides a fast and reliable screening service).
- Cystoscopy with biopsy: endoscopic inspection of the bladder with biopsy collection for histological confirmation.
- Imaging (ultrasound, CT, MRI): to assess bladder wall invasion, possible metastasis or involvement of neighboring organs.
- Emerging biomarkers: a urine test based on MCM5 protein, with high sensitivity and specificity, has been tested in Italy as a possible non-invasive method for screening or early diagnosis.
Staging follows the TNM (Tumor, Lymph Node, Metastasis) system, which takes into account bladder wall invasion (T), lymph node involvement (N), and presence of metastasis (M). Treatment depends on the stage:
- Superficial tumors: endoscopic resection and periodic checkups.
- Invasive tumors: surgery, chemotherapy, radiation therapy.
- Innovative therapies: immunotherapy and targeted drugs.
- Macroscopic hematuria: presence of visible blood in the urine is often the warning sign.
- Urinary cytology: examination of urine to identify free neoplastic cells (Urine24 provides a fast and reliable screening service).
- Cystoscopy with biopsy: endoscopic inspection of the bladder with biopsy collection for histological confirmation.
- Imaging (ultrasound, CT, MRI): to assess bladder wall invasion, possible metastasis or involvement of neighboring organs.
- Emerging biomarkers: a urine test based on MCM5 protein, with high sensitivity and specificity, has been tested in Italy as a possible non-invasive method for screening or early diagnosis.
Staging follows the TNM (Tumor, Lymph Node, Metastasis) system, which takes into account bladder wall invasion (T), lymph node involvement (N), and presence of metastasis (M). Treatment depends on the stage:
- Superficial tumors: endoscopic resection and periodic checkups.
- Invasive tumors: surgery, chemotherapy, radiation therapy.
- Innovative therapies: immunotherapy and targeted drugs.
Bladder cancer on the 2050 horizon: risks and opportunities
In light of global projections of the cancer burden to 2050, it is important to consider how bladder cancer may evolve in the coming decades.
- If the overall cancer trend continues, the absolute number of bladder cancer cases will tend to increase in many areas of the world, especially where smoking, pollution, chemical exposures, and an aging population will increase.
- However, as a neoplasm with well-characterized and "modifiable" risk factors (especially smoking and occupational exposures), there is a relatively clear margin for prevention, potential to be exploited.
- In Italy, considering that advances in early detection and treatment have already helped reduce general cancer mortality, it is desirable that similar advances be applied to bladder cancer, especially through targeted screening in risk groups, noninvasive biomarkers, and advanced imaging technologies.
- If the overall cancer trend continues, the absolute number of bladder cancer cases will tend to increase in many areas of the world, especially where smoking, pollution, chemical exposures, and an aging population will increase.
- However, as a neoplasm with well-characterized and "modifiable" risk factors (especially smoking and occupational exposures), there is a relatively clear margin for prevention, potential to be exploited.
- In Italy, considering that advances in early detection and treatment have already helped reduce general cancer mortality, it is desirable that similar advances be applied to bladder cancer, especially through targeted screening in risk groups, noninvasive biomarkers, and advanced imaging technologies.
Conclusions and public health recommendations
1. Strengthen primary prevention.
2. Improve surveillance and early detection.
3. Invest in therapeutic research.
4. Epidemiological monitoring and health resources.
5. Education and awareness.
2. Improve surveillance and early detection.
3. Invest in therapeutic research.
4. Epidemiological monitoring and health resources.
5. Education and awareness.
How widespread is bladder cancer?
- The reported global incidence in 2022 has increased compared to 2020: from ~573,000 cases to~614,298 cases, an increase of ~7 %.
- Prevalence (people living within 5 years of diagnosis) has also risen: in 2022, an estimated ~1,950,315 people worldwide are estimated to be living within 5 years of diagnosis.
- In Europe, bladder cancer maintains a high position among the most diagnosed cancers in men.
- Prevalence (people living within 5 years of diagnosis) has also risen: in 2022, an estimated ~1,950,315 people worldwide are estimated to be living within 5 years of diagnosis.
- In Europe, bladder cancer maintains a high position among the most diagnosed cancers in men.
Smoking is the main enemy
Cigarette smoking is the number one cause of bladder cancer. The data speak for themselves:
- Those who smoke have up to 4 times more risk of getting sick than those who do not smoke.
- Smoking is linked to more than 50% of cases in men and about 30% in women.
- Even those who have quit for years maintain a higher risk than those who have never smoked, but much lower than active smokers. So: it's never too late to quit!
- Those who smoke have up to 4 times more risk of getting sick than those who do not smoke.
- Smoking is linked to more than 50% of cases in men and about 30% in women.
- Even those who have quit for years maintain a higher risk than those who have never smoked, but much lower than active smokers. So: it's never too late to quit!
Beware of work: some professions are most at risk
Those working in certain industries may be exposed to carcinogenic chemicals, often without knowing it. Those most at risk are:
- Chemical and metal workers.
- Workers in paints, dyes, rubber.
- Mechanics, welders, construction workers.
- Drivers and workers in freight transportation.
A study conducted in Italy showed that some workers had more than twice the risk of getting sick than the general population, even taking smoking into account. The use of personal protective equipment and health surveillance are key to reducing risks.
- Chemical and metal workers.
- Workers in paints, dyes, rubber.
- Mechanics, welders, construction workers.
- Drivers and workers in freight transportation.
A study conducted in Italy showed that some workers had more than twice the risk of getting sick than the general population, even taking smoking into account. The use of personal protective equipment and health surveillance are key to reducing risks.
Diet and lifestyle: they do matter
Although less well known, dietary style affects the risk of getting sick:
- A diet low in fruits and vegetables increases the risk.
- The Mediterranean diet (rich in olive oil, vegetables, whole grains) is protective, especially for smokers.
- A diet low in fruits and vegetables increases the risk.
- The Mediterranean diet (rich in olive oil, vegetables, whole grains) is protective, especially for smokers.
Men more at risk than women
Men get sick 3-4 times more often than women. This is because:
- They smoke more.
- They most often work in risky industries.
- There are also hormonal and biological factors at play.
- They smoke more.
- They most often work in risky industries.
- There are also hormonal and biological factors at play.
Long-term disease and prevention of bladder cancer
Bladder cancer does not appear immediately: it can take 20-30 years from exposure to a harmful substance (such as smoking or a chemical agent at work) to the appearance of the tumor. That is why it is important to act early, even if you feel healthy today.
For those at risk, urinary cytology (analysis of cells in the urine) may be useful, which can help detect cancer early.
There are also home-based services, such as Urine24, that allow testing directly at home.
Bladder cancer is not just a matter of genetics or bad luck. In a great many cases it is preventable. Just know your risks and make more informed choices.
For those at risk, urinary cytology (analysis of cells in the urine) may be useful, which can help detect cancer early.
There are also home-based services, such as Urine24, that allow testing directly at home.
Bladder cancer is not just a matter of genetics or bad luck. In a great many cases it is preventable. Just know your risks and make more informed choices.
