Smoking increases bladder cancer risk by up to four times, says urologist

Smoking is best known for increasing the risk of lung cancer, but doctors warn it can also significantly raise the risk of bladder cancer. According to Dr Ankur Bhatnagar, Senior Consultant and Head - Urology and Kidney Transplant at Sarvodaya Hospital and Research Centre, Faridabad, smokers are two to four times more likely to develop the disease than non-smokers, making tobacco use one of its biggest risk factors.

“Smoking is a major causative factor for urinary bladder cancer. Smoke contains carcinogens that are absorbed in the lungs and travel through the bloodstream into the kidneys, where they are released into the urine. When the bladder stores urine, these cancer-causing substances remain in prolonged contact with the bladder lining and can trigger cancerous changes,” Dr Bhatnagar told India Today.

WHY SMOKING AFFECTS THE BLADDER

Unlike lung cancer, where tobacco smoke directly affects the lungs, bladder cancer develops when harmful chemicals from cigarettes are filtered by the kidneys and released into the urine. These toxins remain in contact with the bladder lining, increasing the risk of cellular damage overtime.

"Cigarette smoke contains numerous carcinogens that reach the bladder through urine. These substances induce DNA damage, leading to uncontrolled growth of cells and eventually cancer," Dr Bhatnagar explained.

THE WARNING SIGN PEOPLE OFTEN IGNORE

Blood in the urine is often the first sign of bladder cancer, but many people ignore it, assuming it is harmless or temporary.

"Bleeding in bladder cancer occurs mainly from tumour blood vessels. These blood vessels are fragile and prone to bleed. Blood in urine is usually the first symptom, and people should promptly consult a urologist for early diagnosis and timely treatment," Dr Bhatnagar said.

The intermittent nature of the symptoms can make it easy to dismiss.

"Most people tend to believe that haematuria, or blood in urine, is due to a hot and spicy meal they had the previous day. Since the bleeding is often not continuous, they ignore it and delay visiting a urologist, which can delay diagnosis and treatment," he added.

OTHER SYMPTOMS TO WATCH OUT FOR

While blood in the urine remains the most common symptom, some patients may experience other urinary complaints.

Dr Bhatnagar said bladder cancer can sometimes present with:

• Burning sensation while passing urine
• Frequent urination
• Persistent urinary irritation

These symptoms can resemble common urinary infections, which is why they are often overlooked.

WHO IS AT HIGHER RISK?

Smoking remains the biggest risk factor, but it is not the only one.

Dr Bhatnagar said bladder cancer is most commonly diagnosed in people in their 60s. Individuals working in industries involving dyes, pigments, leather, rubber, plastics and diesel-related dust may also face a higher risk because of long-term exposure to certain chemicals.

According to previous research, smoking may account for nearly half of all bladder cancer cases, with the risk being highest among heavy smokers and those who start smoking at a young age.

WHEN TO SEE A DOCTOR

Consult a doctor if you experience:

• Blood in urine, even once
• Burning sensation while urinating that does not improve
• Frequent urination without an obvious cause
• Persistent urinary irritation
• A history of smoking along with urinary symptoms

DOES QUITTING SMOKING HELP?

The answer is yes.

“Quitting smoking reduces the risk of bladder cancer, and the reduction in risk increases over time. However, even years after quitting, the overall risk remains higher than that of someone who has never smoked,” Dr Bhatnagar said.

WHY EARLY DETECTION MATTERS

Doctors say increasing awareness and better access to specialist care are helping more patients receive a diagnosis at an earlier stage.

“Currently, because of increasing awareness among the public and easier access to specialists, the trend is shifting toward diagnosis at an early stage and better prognosis after treatment,” Dr Bhatnagar said.

However, he warned that smoking among younger people remains a growing concern.

“With current lifestyle trends, where smoking has become rampant among young people, the incidence of the disease is being seen in younger age groups as well,” he added.

“Blood in urine should never be ignored. Early diagnosis can significantly improve treatment outcomes,” Dr Bhatnagar said.

For smokers, doctors say paying attention to even a single episode of blood in the urine could make the difference between early treatment and a delayed diagnosis.