Bladder cancer is the most common malignancy involving the urinary system. In 2020 it was the 10th most common cancer with 573,278 new cases worldwide (440,864 men and 132,414 women) .
Several risk factors are associated with the development of bladder cancer [2-4]. There is strong evidence linking bladder cancer to exposure to carcinogens, in particular the use of tobacco, especially cigarettes. It is estimated that up to half of all bladder cancers are caused by cigarette smoking and that smoking increases a person’s risk of bladder cancer two to four times above baseline risk . In addition, occupational exposure to chemicals in processed paint, dye, metal, and petroleum products are associated with the development of bladder cancer [2-4]. Occurrence of genetic mutations in some chromosomal genes that play an important role in the regulation of cell division, lead to tumours in the urinary bladder .
Blood in urine, often referred to as hematuria, is the most common first symptom or sign of bladder cancer . When bladder cancer is suspected, the most useful diagnostic test is cystoscopy which can be performed in a urology clinic. If cancer is suspected on cystoscopy, the patient is typically scheduled for a bimanual examination under anaesthesia and a repeat cystoscopy in an operating room so that transurethral resection of bladder tumour(s) (TURBT) and/or biopsies can be performed. Urothelial carcinomas are often multifocal – the entire urothelium needs to be evaluated if a tumour is found. If a high-grade cancer (including carcinoma in situ) or invasive cancer is detected, the patient is at high risk for extra-bladder tumour dissemination [6-10].