Bladder cancer

Nat Rev Dis Primers. 2017 Apr 13;3:17022. doi: 10.1038/nrdp.2017.22.


Bladder cancer is a highly prevalent disease and is associated with substantial morbidity, mortality and cost. Environmental or occupational exposures to carcinogens, especially tobacco, are the main risk factors for bladder cancer. Most bladder cancers are diagnosed after patients present with macroscopic haematuria, and cases are confirmed after transurethral resection of bladder tumour (TURBT), which also serves as the first stage of treatment. Bladder cancer develops via two distinct pathways, giving rise to non-muscle-invasive papillary tumours and non-papillary (solid) muscle-invasive tumours. The two subtypes have unique pathological features and different molecular characteristics. Indeed, The Cancer Genome Atlas project identified genetic drivers of muscle-invasive bladder cancer (MIBC) as well as subtypes of MIBC with distinct characteristics and therapeutic responses. For non-muscle-invasive bladder cancer (NMIBC), intravesical therapies (primarily Bacillus Calmette-Guérin (BCG)) with maintenance are the main treatments to prevent recurrence and progression after initial TURBT; additional therapies are needed for those who do not respond to BCG. For localized MIBC, optimizing care and reducing morbidity following cystectomy are important goals. In metastatic disease, advances in our genetic understanding of bladder cancer and in immunotherapy are being translated into new therapies.

Publication types

  • Review

MeSH terms

  • Biomarkers / analysis
  • Cystectomy / methods
  • DNA-Binding Proteins / analysis
  • DNA-Binding Proteins / blood
  • E2F3 Transcription Factor / analysis
  • E2F3 Transcription Factor / blood
  • Humans
  • Neoadjuvant Therapy / methods
  • Occupational Exposure / adverse effects
  • Quality of Life / psychology
  • Receptor, Fibroblast Growth Factor, Type 3 / analysis
  • Receptor, Fibroblast Growth Factor, Type 3 / blood
  • Retinoblastoma Binding Proteins / analysis
  • Retinoblastoma Binding Proteins / blood
  • Risk Factors
  • Smoking / adverse effects
  • Tuberous Sclerosis Complex 1 Protein
  • Tumor Suppressor Proteins / analysis
  • Tumor Suppressor Proteins / blood
  • Ubiquitin-Protein Ligases / analysis
  • Ubiquitin-Protein Ligases / blood
  • Urinary Bladder Neoplasms / complications*
  • Urinary Bladder Neoplasms / diagnosis*


  • Biomarkers
  • DNA-Binding Proteins
  • E2F3 Transcription Factor
  • E2F3 protein, human
  • RB1 protein, human
  • Retinoblastoma Binding Proteins
  • TP53TG1 protein, human
  • Tuberous Sclerosis Complex 1 Protein
  • Tumor Suppressor Proteins
  • Ubiquitin-Protein Ligases
  • FGFR3 protein, human
  • Receptor, Fibroblast Growth Factor, Type 3