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Etiology of bladder cancer

In most cases, the cause of urothelial cancer is unclear. However, it is known that this cancer type was previously an occupational disease associated with certain chemical industries before environmental policies were adapted, mostly in the paint and color industry.

Certain medications are suspected to have a detrimental effect on developing urothelial cancer. Molecular biology techniques have identified mutations on chromosome 9 and 17, as significant etiological and prognostic factors for developing urothelial cancer (2).

Carcinogens 

It is likely that different types of pollution contain carcinogens that are excreted in urine and involve urothelial cells, causing mutations. The bladder, where urine is stored the longest, is clearly the most frequent location for primary tumors. 

Smoking

Urothelial cancer is diagnosed most often in people who smoke or were smokers. In heavy smokers, aggressive urothelial cancer occurs more frequently (6).

Chronic irritation/infections

Chronic irritation of the urothelium due to calculi and chronic infections (especially Bilharzia) can develop into cancer. In these cases, squamous epithelial cancer develops (2).

Previous radiation therapy/chemotherapy 

Patients who, at a young age, had radiation therapy to the bladder region as part of treatment of another cancer type (sarcoma, testicular cancer, gynecological cancers) have an increased risk of developing bladder cancer in the long run (1).

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