Can Your Habits Help Prevent Bladder Cancer… Even if It Runs in the Family

Bladder cancer doesn't get as much airtime as other cancers, but it should. It's the 10th most common cancer worldwide, with over 600,000 new cases each year and more than 200,000 deaths annually.¹

Recent research is showing that both genetics and lifestyle play a role in bladder cancer. The twist? Even if you've inherited a higher risk, your daily habits could still tip the scales in your favor.

Numbers and Contributing Factors

Bladder cancer rates are highest in developed countries, and the incidence seems to be higher in men: in Norway, for instance, it's the 4th most common cancer, and men in general are 3-4 times more likely to be diagnosed than women.²

Historically, smoking and occupational exposure (like long-term contact with industrial chemicals and hydrocarbons) have been the top culprits. But here's the catch: even as smoking rates fall and workplace safety improves, bladder cancer rates haven't declined around the globe, especially in the geographical locations you'd expect. That suggests other contributors are at play.

Spoiler alert: Researchers are exploring those "other contributors" and finding that diet, exercise, weight, and genetics play a part.

Lifestyle Choices

Several lifestyle-related habits are known to affect cancer risk in general - things like smoking, obesity, physical inactivity, and poor diet. One large study from the UK Biobank tracked 375,998 people over nearly 12 years and found that people who followed a healthy lifestyle (non-smokers, physically active, eating a decent diet, and maintaining a healthy weight) had a roughly 50% lower risk of developing bladder cancer compared to those with poor lifestyle habits, even after accounting for genetic risk.³

In men from the Norwegian study, physical activity seemed to protect against bladder cancer, particularly among never-smokers. On the flip side, elevated blood pressure, particularly diastolic blood pressure (the bottom number in your BP reading), was linked to a higher risk. And this risk was even more substantial in men who never smoked. This means that both smoking and hypertension are independent risk factors and need to be addressed.⁴

And about that smoking habit - yes, we all know it's bad. But this research drove it home: smoking status was the strongest individual lifestyle factor tied to bladder cancer risk. Researchers also noted that quitting helps, even after years of use.

The Genetic Wild Card

Genetics plays a role in our health, no doubt about it. Scientists can now calculate a polygenic risk score (PRS) based on genetic variants - essentially a number that estimates your inherited risk - and one study estimated that about 30% of bladder cancer risk comes from inherited factors.⁵

In the UK Biobank study⁵, people with high PRS had a 63% higher risk of bladder cancer compared to those with low PRS. But here's where it gets hopeful: those with high genetic risk who also followed a healthy lifestyle still saw nearly 50% lower risk than their counterparts with poor habits. Translation? Your DNA isn't your destiny.

While genetics is an influencing factor, the habits you maintain can work independently of your inherited risk. So, whether your genes love you or not, healthy living helps.

Good Habits Are Always In Style

Let's talk about what "good habits" actually look like:

• Don't smoke. We said it earlier, we'll say it again. It's the single most important lifestyle change for bladder cancer prevention. (Plus some!)
• Move more. Physical activity, even moderate levels, can lower your risk of not just cancer but multiple systemic health issues.
• Eat your greens (and skip the Western fast-food routine). Diets resembling the Mediterranean pattern seem to help, while "Western" diets heavy in processed foods and red meat are associated with a higher risk.5
• Watch your blood pressure. Hypertension showed up as an independent risk factor in men, especially for those who had never smoked. So those regular checkups? Worth it.⁶

Just doing some of these things, even if not all of them, still lowers the risk.

If you've been looking for a nudge to quit smoking, get moving, or finally learn to cook a vegetable, let this be it. Even minor lifestyle improvements can make a measurable difference in your bladder health, overall well-being, and potentially your future.

And if you're wondering where to start, talk to the team at Georgia Urology. Whether you've noticed symptoms or you just want to take a more proactive approach to your urologic health, now's the time.

References:

1. He, Q., Wu, S., Zhou, Y., Liu, Y., Xia, B., Li, W., Zhao, J., Mi, N., Xie, P., Qin, X., Yuan, J., & Pan, Y. (2023). Genetic factors, adherence to healthy lifestyle behaviors, and risk of bladder cancer. BMC cancer, 23(1), 965. https://doi.org/10.1186/s12885-023-11455-4.
2. Hektoen, H. H., Robsahm, T. E., Andreassen, B. K., Stenehjem, J. S., Axcrona, K., Mondul, A., & Gislefoss, R. E. (2020). Lifestyle associated factors and risk of urinary bladder cancer: A prospective cohort study from Norway. Cancer medicine, 9(12), 4420-4432. https://doi.org/10.1002/cam4.3060.
3. He, Q., Wu, S., Zhou, Y., Liu, Y., Xia, B., Li, W., Zhao, J., Mi, N., Xie, P., Qin, X., Yuan, J., & Pan, Y. (2023). Genetic factors, adherence to healthy lifestyle behaviors, and risk of bladder cancer. BMC cancer, 23(1), 965. https://doi.org/10.1186/s12885-023-11455-4.
4. Hektoen, H. H., Robsahm, T. E., Andreassen, B. K., Stenehjem, J. S., Axcrona, K., Mondul, A., & Gislefoss, R. E. (2020). Lifestyle associated factors and risk of urinary bladder cancer: A prospective cohort study from Norway. Cancer medicine, 9(12), 4420-4432. https://doi.org/10.1002/cam4.3060.
5. He, Q., Wu, S., Zhou, Y., Liu, Y., Xia, B., Li, W., Zhao, J., Mi, N., Xie, P., Qin, X., Yuan, J., & Pan, Y. (2023). Genetic factors, adherence to healthy lifestyle behaviors, and risk of bladder cancer. BMC cancer, 23(1), 965. https://doi.org/10.1186/s12885-023-11455-4.
6. Hektoen, H. H., Robsahm, T. E., Andreassen, B. K., Stenehjem, J. S., Axcrona, K., Mondul, A., & Gislefoss, R. E. (2020). Lifestyle associated factors and risk of urinary bladder cancer: A prospective cohort study from Norway. Cancer medicine, 9(12), 4420-4432. https://doi.org/10.1002/cam4.3060.