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NH Environmental Public Health Tracking Program
Bladder Cancer

The bladder is the organ in the body that stores urine before it leaves the body. The inside of the bladder is lined with a layer of cells called urothelial cells. The same type of cell also lines the kidneys, the tubes connecting the kidneys to the bladder (ureters), and the urethra, which are all part of the urinary system. Cancer can begin in the lining cells in any of these organs. As the cancer grows deeper into the layers of the wall of the bladder, it becomes harder to treat. Bladder cancer is more common among older persons, more common among men, and occurs more frequently in white persons.

Recurrence of bladder cancer is common so consequently, the prevalence of bladder cancer is high. Incidence rates of bladder cancer vary geographically with higher rates in the northeastern United States. Known risk factors such as smoking and occupational exposures do not explain the geographic variations.

Bladder Cancer and the Environment

The relationship between bladder cancer and drinking water contamination has been researched extensively. High levels of arsenic in drinking water have been well established as causing cancer.

Exposure and Risk

Smoking is the greatest risk factor associated with bladder cancer. Persons who smoke have more than twice the risk for bladder cancer than non-smokers. Research indicates that smoking causes approximately 20%-30% of bladder cancers among women and 50%-65% among men.

Ingestion of high levels of inorganic arsenic can cause cancer. The effect of low-to-moderate arsenic levels in drinking water is less definitive. Long-term exposure to disinfection by-products in drinking water may also cause a small increase in the risk for bladder cancer.

Workplace exposures may also increase the risk for bladder cancer. Studies show that workers in the trucking, dye, rubber, textile, leather, and chemical industries have a higher risk for bladder cancer. Approximately 5%-25% of bladder cancers among men and 8%-11% among women are associated with occupational exposures.

Reduce Your Risk

Not smoking is the most important behavior to reduce bladder-cancer risk. The risk for bladder cancer among smokers who quit smoking returns to normal eventually. Workplace exposures may also increase the risk for bladder cancer. Applicable health and safety rules, like wearing protective equipment, should be adhered to in high-risk jobs.

For more information on bladder cancer:

Environmental Public Health Tracking Program
NH Department of Health and Human Services, Division of Public Health Services
29 Hazen Drive, Concord, NH 03301
Tel: (603) 271-4988 800-852-3345 ext.4988

copyright 2009. State of New Hampshire