Bladder Cancer Awareness Month: Knowing the Warning Signs

The month, and why it exists

The Bladder Cancer Advocacy Network marks Bladder Cancer Awareness Month each May. BCAN calls it a time to draw notice to a disease that affects more than 725,000 people in the United States. The month is used to talk about symptoms, risk factors, and treatment.

There is a plain reason a month is needed. The main warning sign is blood in the urine. Blood in the urine is very often caused by something else. That makes it easy to see and easy to shrug off.

The one sign that matters most

Blood in the urine is called hematuria. It comes in two forms. Gross hematuria you can see: urine that looks pink, red, or the color of cola. Microscopic hematuria you cannot, and it shows up only on a urine test.

Either counts. NCI's health-professional summary says bladder cancer usually shows up as gross or microscopic hematuria. Less often, people pass urine more often, wake at night to do so, or feel pain or burning. NCI notes those are more common with carcinoma in situ, a flat, high-grade cancer that sits in the bladder lining.

Bleeding from bladder cancer is often painless, and it can come and go. One episode that clears on its own is still worth an appointment. Our page on bladder cancer symptoms covers what happens at that visit.

What the disease is

The bladder is a hollow organ that stores urine. Its lining is a special tissue called urothelium, which also lines the tubes above and below it.

Most bladder cancers are urothelial carcinomas, also called transitional cell carcinomas. They start in that lining. Squamous cell carcinomas, adenocarcinomas, small cell carcinomas, and sarcomas can form there too, but far less often.

Two splits matter more than the cell type. The first is grade. NCI says low-grade bladder cancer often comes back in the bladder, but rarely invades the muscle wall or spreads. People rarely die of it. High-grade disease also comes back, but tends to invade and spread. Almost all deaths from bladder cancer come from it.

The second split is depth. Non-muscle-invasive disease has not reached the thick detrusor muscle in the bladder wall. It can often be treated by removing the tumor through the urethra, sometimes with drugs put into the bladder through a catheter. Muscle-invasive disease is usually treated by removing the bladder, or by radiation with chemotherapy. Our page on bladder cancer stages explains how the two splits combine.

What raises the risk

NCI names tobacco, and cigarettes above all, as a major risk factor. The chemistry is direct. Carcinogens from tobacco pass into the blood, are filtered by the kidneys, then sit in the urine. That leaves the bladder lining bathed in them.

NCI's other listed risk factors are:

• A family history of bladder cancer
• Certain gene changes, including HRAS, RB1, PTEN/MMAC1, NAT2, and GSTM1
• Workplace exposure to paints, dyes, metals, or petroleum products
• Past pelvic radiation, or treatment with cyclophosphamide or ifosfamide
• Taking the Chinese herb Aristolochia fangchi
• Well water with high arsenic levels, or chlorinated drinking water
• Infection with the parasite Schistosoma haematobium, common in Africa and the Middle East and rare in the United States
• Long-term use of urinary catheters

NCI adds that in the United States bladder cancer occurs more often in men than women, and more often in White than in Black individuals. Risk rises with age.

Why there is no routine screening test

NCI states there is no standard screening test for bladder cancer in people at average risk. Some tests are used for people who have had bladder cancer before, or who are at raised risk. These are a hematuria test, urine cytology, urine tumor marker tests, and cystoscopy.

The reason for holding back sits in the tests themselves. NCI notes that false positives are common with hematuria testing, because blood in the urine usually has another cause. Each one leads to more tests, including cystoscopy, which has its own risks. False negatives cut the other way and can delay care in someone who does have the disease.

When to get checked

Book an appointment for any of these:

• Visible blood in the urine, once, even if it clears and even if it does not hurt
• Blood found on a routine urine test with no infection to explain it
• Needing to pass urine much more often, or waking at night to do so
• Burning or pain on passing urine that antibiotics do not fix
• One-sided flank pain that persists

If you use tobacco, quitting lowers risk. If your work involves paints, dyes, metals, or petroleum products, workplace protections are the lever you have.

What this does not mean

• Blood in the urine is far more often caused by infection, stones, or an enlarged prostate. The point is to find out which.
• "No standard screening test" is not the same as "nothing can be done." It means no test has yet been shown to be safe, accurate, and useful for people at average risk.
• Having risk factors does not mean someone will get bladder cancer. Plenty of people with no known risk factors do.
• Low-grade and high-grade disease behave so differently that survival figures for one say little about the other.
• Nothing here can tell you what your symptom means. That takes a clinician and, usually, a look inside the bladder.

Sources

• Bladder Cancer Advocacy Network, 2026 Bladder Cancer Awareness Month — https://bcan.org/bladder-cancer-awareness-month-2026/
• NCI, Bladder Cancer Causes and Risk Factors — https://www.cancer.gov/types/bladder/causes-risk-factors
• NCI, Bladder Cancer Screening — https://www.cancer.gov/types/bladder/screening
• NCI PDQ, Bladder Cancer Treatment (Health Professional Version) — https://www.cancer.gov/types/bladder/hp/bladder-treatment-pdq

How this article was prepared

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

The National Cancer Information Foundation publishes Cancer Explained. This page is for learning. It is not medical advice and does not suggest a test or treatment.

See an error, old source, or unclear wording? Tell us.