Urinary tract infections (UTIs) are a common health issue that can cause discomfort and make daily life harder. In the United States, UTIs lead to about 10.5 million doctor visits each year.

UTIs can cause uncomfortable symptoms that are similar to those of bladder cancer. When diagnosing bladder cancer, your health care provider will work to determine whether your symptoms are caused by a UTI or bladder cancer. In this article, we’ll explore the connection between UTIs and bladder cancer.

What Is a UTI?

A UTI is an infection that can affect any part of the urinary system, including the bladder, kidneys, ureters (the tubes that carry urine from the kidneys to the bladder), or urethra (the tube that carries urine out of the body). Most UTIs are uncomplicated and happen in the bladder, which is called cystitis.

UTIs can happen when bacteria (a germ) enter the urethra and travel to the bladder. The most common bacteria responsible for UTIs is Escherichia coli (E. coli), which is normally found near the opening of the urethra.

UTIs are usually treated with antibiotics, which kill the bacteria causing the infection.

UTIs Have Similar Symptoms as Bladder Cancer

In the early stages, UTIs and bladder cancer may feel the same. Symptoms of both conditions may include:

• Frequent urination (pollakiuria)
• Urgency to urinate
• Pain while urinating (dysuria)
• Blood in the urine (hematuria)
• Pelvic or lower back pain

Because the symptoms are so similar, it can be difficult to tell the difference between a UTI and bladder cancer, especially in its early stages. However, your health care provider can usually get clues by looking at your most bothersome symptoms and your medical history. For example, blood in the urine is the most common early symptom of bladder cancer. However, bladder cancer isn’t the most common cause of blood in the urine. A UTI is more likely to cause this symptom. Other symptoms that are more common in UTIs are:

• Fever
• Pus in the urine (pyuria) or puslike discharge from the urethra
• A burning sensation when urinating
• Bad-smelling urine

It’s also important to note that UTIs are most common in women, while bladder cancer is about three times more common in men, especially among those who smoke or have smoked in the past. However, because bladder cancer is less common in women while UTIs are more common, it can lead to missing the early signs of the disease.

UTIs and bladder cancer aren’t the only conditions that cause these symptoms. Other conditions, like kidney stones, an enlarged prostate, and certain medications, can also cause blood in the urine. If your health care provider thinks something else might be causing your symptoms, they may test for those conditions too.

Diagnostic Tests Can Tell the Difference Between UTIs and Bladder Cancer

If you have urinary symptoms, your health care provider will order tests to try to figure out the cause.

A urinalysis and urine culture can help diagnose a UTI. For both tests, you’ll provide a urine sample. In a urinalysis, a laboratory will look at your urine under a microscope to check for blood and bacteria. They’ll also test for other factors, including:

• Blood — Blood in your urine could be caused by a UTI or bladder cancer. Even if you don’t see blood in your urine, there may still be microscopic amounts that are not visible to the naked eye.
• Nitrites — If the test shows nitrites, it usually means you have a UTI, because certain bacteria make nitrites.
• White blood cells — A significant number of white blood cells in your urine means there is inflammation in your urinary tract.
• Leukocyte esterase — If this test is positive, it means you have inflammation in your urinary tract.

A urine culture checks if bacteria or other germs are growing in your urine sample. A urine culture can help doctors identify the type of bacteria causing the infection and decide on the best treatment. Aside from identifying which bacteria are causing the UTI, a urine culture can also guide doctors in choosing the right antibiotics for your UTI.

If you don’t respond to appropriate UTI treatment or if your health care provider suspects you may also have bladder cancer, you may need additional testing. It’s also possible to have a UTI and bladder cancer at the same time.

If you’ve been treated by your primary care provider, you may be referred to a urologist — a health care provider who specializes in treating urinary tract and male reproductive problems. Some urologists specialize in female urology, addressing conditions unique to women. Your urologist can perform additional testing to look for bladder cancer. An imaging test, such as an ultrasound or computed tomography (CT) scan, can create detailed images of the inside of your body to look for signs of bladder cancer. A cystoscopy is a test used to diagnose bladder cancer. In a cystoscopy, your urologist will insert a thin tube into your bladder through your urethra to look for signs of bladder cancer.

In some cases, you may be referred to an infectious disease specialist or a gynecologist. These types of doctors are trained to treat UTIs and other related conditions.

Frequent UTIs May Increase Your Risk of Bladder Cancer

Chronic (long-term) UTIs may increase your risk of bladder cancer. However, it’s important to know that most people with frequent UTIs don’t ever get bladder cancer. Even though frequent UTIs aren’t necessarily considered to be a symptom of cancer, they may prompt your doctor to do further tests to rule out bladder cancer.

Cancer researchers have known about the link between UTIs and bladder cancer for many years. A review from 2024 found that a type of bladder cancer called squamous cell carcinoma (SCC) is often linked to long-term bladder irritation and inflammation, which can be caused by UTIs. Chronic UTIs, in particular, can lead to changes in the bladder lining, which may increase the risk of SCC. Other studies have also found a connection between UTIs and an increased risk of bladder cancer, especially in men, according to the International Journal of Environmental Research and Public Health.

While many factors can cause bladder cancer, the inflammation from a UTI may also contribute to the higher risk of bladder cancer. When your bladder becomes inflamed, your body replaces damaged cells with new ones. Every time your cells multiply and divide, it creates an opportunity for a genetic mutation (change) that could eventually cause bladder cancer.

Risk Factors for UTIs

Certain groups of people are more likely to develop a UTI. In general, those with a vagina are more likely to develop a UTI because of their anatomy. According to Cleveland Clinic, the urethra is much shorter and straighter in people assigned female at birth, giving bacteria a shorter distance to travel to the bladder. Additionally, the urethra is closer to the anus, where E. coli bacteria are commonly found. Other risk factors for UTIs in women include sexual activity, using barrier contraceptives, and menopause, according to Mayo Clinic.

People who live in Africa and the Middle East have an increased risk of schistosomiasis, a bladder infection caused by a parasitic worm. Schistosomiasis is linked to an increased risk of bladder cancer. However, this infection is rare in the U.S.

Other UTI risk factors may include:

• Urinary tract blockage, most commonly from a stone
• Weak immune system
• Recent urinary tract procedures
• Use of a catheter to urinate
• Urinary tract problems from birth

UTIs Can Occur During Bladder Cancer Diagnosis and Treatment

Bladder cancer treatment may increase your risk of developing a UTI. Below, we’ll review how UTI risk factors are linked to bladder cancer diagnosis or its treatment.

Urinary Tract Blockage

If a bladder tumor presses on the ureters or urethra, it can block the flow of urine. When urine is trapped in the bladder, it increases the risk of a UTI. Talk to your cancer care team right away if you notice any changes in your urinary habits.

Weak Immune System

Chemotherapy for bladder cancer can weaken your immune system. When your immune system isn’t working as well, it can be easier for bacteria to cause an infection. UTIs are also a possible side effect of some immunotherapy drugs. Radiation therapy in your pelvis can also irritate your bladder or other parts of your urinary tract, which may lead to an infection.

Additionally, some chemotherapy drugs and bladder tumors can break down the bladder wall, providing harmful bacteria a place to enter and hide. Cancer cells also have a natural ability to escape the immune system, which can make bacterial infections more likely.

Recent Urinary Procedures

Urinary procedures and surgeries are part of the diagnosis and treatment of bladder cancer. Using medical instruments around your urinary tract can create an opening for bacteria to enter and infect your bladder, leading to a UTI.

Using a Catheter To Urinate

People who have surgery to remove their bladder (cystectomy) may need to use a catheter (drainage tube) to allow urine to leave the body. Using a catheter can increase the risk of bacteria entering the urinary system. Your cancer care team can help you learn sanitary practices to help reduce your risk of a UTI while using a catheter.

Talk With Others Who Understand

MyBladderCancerTeam is the social network for people with bladder cancer and their loved ones. On MyBladderCancerTeam, members come together to ask questions, give advice, and share their stories with others who understand life with bladder cancer.

Have you had UTIs during bladder cancer diagnosis or treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.