Cancer screening exams can help find bladder cancer at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose bladder cancer early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

Screening for Bladder Cancer

Cancer screening exams can help find cancer at its earliest stage, when the chances for successful treatment are greatest. These tests are usually done when you are healthy and have no specific symptoms.

For people who are at very high risk for bladder cancer, such as those previously diagnosed with bladder cancer, doctors may recommend certain, regular screening exams.

Tests and procedures to screen for bladder cancer may include the following:


A cystoscopy is a procedure that uses a thin tube inserted through the urethra and into the bladder to check for any abnormal tissues. If any tissue samples need to be taken, they may be taken during this procedure.

Urine Cytology

A urine sample is examined a sample of urine under a microscope to check for the presence of cancer cells.

Hematuria Tests

Special test strips can detect blood in the urine – a condition called Hematuria.

This may also be caused by other conditions other than cancer.

(Source: National Cancer Institute)

Bladder Cancer Risk Factors

A bladder cancer risk factor is anything that increases your chances of developing bladder cancer.

Smoking is a significant risk factor for bladder cancer. Carcinogens (cancer-causing agents) from cigarette smoke can become concentrated in the urine and over time can damage the bladder's lining. Studies suggests that smokers are three times more likely to develop bladder cancer than nonsmokers.

Other risk factors include:

  • Having a family history of bladder cancer
  • Having certain changes in the genes that are linked to bladder cancer
  • Being exposed to certain chemicals in the workplace
  • Past radiation therapy to the pelvis
  • Taking Aristolochia fangchi, a Chinese herb
  • Drinking well water that has high levels of arsenic
  • Drinking water that has been treated with chlorine
  • Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium
  • Using urinary catheters for a long time

(Source: National Cancer Institute)

Not everyone with risk factors will get bladder cancer. But having certain risk factors may increase your risk of developing the disease. If you are at high risk for bladder cancer, talk to your doctor about tests to find out if you have early signs of the disease.

Diagnosing Bladder Cancer

If bladder cancer is suspected, your OSUCCC – James expert will examine you and record your medical history and any symptoms and risk factors you may have. These experts may also conduct the following tests to form a diagnosis:

Internal Exam

An exam to check the vagina or rectum for any lumps or unusual tissue abnormalities.


Urine color and contents are checked for the presence and level of substances such as sugar and red or white blood cells.

Urine Cytology

A urine sample is examined under a microscope to look for any unusual or abnormal cells.


A cystoscope (a thin, tube-like instrument) is used to look inside the bladder and urethra to check for any abnormal areas. If tissue samples are needed, they can be removed during this procedure.

Intravenous Pyelogram (IVP)

A series of X-rays of the kidneys, ureters and bladder to check for cancer. A contrast dye is used during this procedure to help the OSUCCC – James expert see any blockages.


A piece of tissue or tumor is removed from the body so that a specially trained OSUCCC – James pathologist can examine the cells under a microscope for any signs of cancer.

(Source: National Cancer Institute)

Genitourinary Biomarker Testing 

Staging Bladder Cancer

If you are diagnosed with bladder cancer, staging is just one of many ways your OSUCCC – James cancer experts can determine the amount and location of your cancer, and it can help them choose the most effective, personalized treatment options for you.

Bladder cancer may be classified as one of five stages:

Stage 0 (Papillary Carcinoma and Carcinoma in Situ)

Abnormal cells are found in tissue that lines the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue.

Stage 0 is divided into stage 0a and stage 0is, depending on the type of the tumor:

  • Stage 0a is also called papillary carcinoma, and it may look like tiny mushrooms growing from the lining of the bladder.
  • Stage 0is is also called carcinoma in situ, and it is a flat tumor on the tissue lining the inside of the bladder.
Bladder Cancer Stage 0

Stage I

In stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.

Stage II

In this stage, cancer has spread to the layers of muscle tissue of the bladder.

Stage III

In this stage, cancer has spread from the bladder to the layer of fat surrounding it and may have spread to the reproductive organs (prostate, seminal vesicles, uterus or vagina).

Stage IV

In stage IV, one or more of the following is true

  • Cancer has spread from the bladder to the wall of the abdomen or pelvis
  • Cancer has spread to one or more lymph nodes
  • Cancer has spread to other parts of the body, such as the lung, bone or liver

(Source: National Cancer Institute)

If you’ve been diagnosed with bladder cancer, would like a second opinion or would like to speak with a bladder cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210

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