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Can Bladder Cancer Be Found Early?

Bladder cancer can sometimes be found early, when it's small and hasn't spread beyond the bladder. Finding it early improves your chances that treatment will work.

Screening for bladder cancer

Screening is the use of tests or exams to look for a disease such as cancer in people who have no symptoms.

For people at average risk

At this time, major professional organizations don’t recommend routine screening for bladder cancer for most people. This is because screening has not been shown to lower the risk of dying from bladder cancer in people at average risk.

For people at high risk of bladder cancer

Some doctors or other providers may recommend bladder cancer screening for people who have factors that strongly increase their risk of bladder cancer, such as:

  • Having had bladder cancer before
  • Having had certain birth defects of the bladder
  • Exposure to certain chemicals at work

While screening might be helpful for some people with these risk factors, this hasn’t been proven in large studies.

Tests that might be used to look for bladder cancer

Most tests for bladder cancer look for different substances and/or cancer cells in the urine.

Urinalysis: One way to test for bladder cancer is to check for blood in the urine (hematuria). This can be done during a urinalysis, which is a simple test to check for blood and other substances in a sample of urine. This test is sometimes done as part of a general health check-up.

Blood in the urine is usually caused by benign (non-cancer) problems, like infections, but it also can be the first sign of bladder cancer. Large amounts of blood in urine can be seen if the urine turns pink or red, but a urinalysis can find even small amounts.

Urinalysis can help find some bladder cancers early, but it has not been shown to be useful as a routine screening test.

Urine cytology: In this test, a microscope is used to look for cancer cells in urine. Urine cytology can find some bladder cancers, but it's not reliable enough to make a good screening test.

Urine tests for biomarkers: Newer tests look for certain substances in urine (known as biomarkers or tumor markers) that might be a sign of bladder cancer. These include tests such as:

  • UroVysion
  • Bladder tumor antigen (BTA) tests
  • ImmunoCyt
  • NMP22 BladderChek

Many other urine biomarker tests are being developed as well. These types of tests might find some bladder cancers early, but they can miss some as well. And sometimes a test result might be abnormal even in people who do not have cancer.

At this time, these tests are used mainly to look for bladder cancer in people who already have signs or symptoms of it, or to watch for signs that bladder cancer has come back (recurred) in people who have had it removed. To learn more about these tests, see Tests for Bladder Cancer.

More research is needed to know if these or other tests are useful as screening tests.

Watching for possible symptoms of bladder cancer

While screening isn’t recommended for people at average risk, bladder cancer can still sometimes be found early if it causes blood in the urine or other urinary symptoms. (See Bladder Cancer Signs and Symptoms for details.)

Many of these symptoms often have less serious causes, but it’s important to have them checked right away so the cause can be found and treated, if needed. If the symptoms are from bladder cancer, finding it early offers the best chance for successful treatment.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Campbell SC. Screening for bladder cancer. UpToDate. 2023. Accessed at https://www.uptodate.com/contents/screening-for-bladder-cancer on October 16, 2023.

Cheng X, Liu X, Liu X, et al. Metabolomics of non-muscle invasive bladder cancer: Biomarkers for early detection of bladder cancer. Front Oncol. 2018;8:494.

Mitra AP, Birkhahn M, Penson DF, Cote RJ. Urine biomarkers for the detection of urothelial (transitional cell) carcinoma of the bladder. UpToDate. 2023. Accessed at https://www.uptodate.com/contents/urine-biomarkers-for-the-detection-of-urothelial-transitional-cell-carcinoma-of-the-bladder on October 16, 2023.

National Cancer Institute. Bladder Cancer Screening. 2023. Accessed at https://www.cancer.gov/types/bladder/screening on October 16, 2023.

Smith AB, Balar AV, Milowsky MI, Chen RC. Chapter 80: Carcinoma of the Bladder. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Last Revised: March 12, 2024

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