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Peer-reviewedCC BY-NC 4.0Bju International

Diet and risk of bladder cancer: a systematic review of epidemiological evidence

  • Keiichiro Miyajima1,2
  • Marcin Miszczyk1,3
  • Navid Roessler1,4
  • Shota Inoue1,5
  • Paweł Rajwa1,6,7
  • Akihiro Matsukawa1,2
  • Fumihiko Urabe2
  • Keiichiro Mori1,2
  • Takafumi Yanagisawa1,2
  • Pierre I. Karakiewicz8
  • Jeremy Yuen‐Chun Teoh9
  • Alberto Briganti10
4 more authors
  • Lin Yang11,12
  • Eva Schernhammer13,14
  • Takahiro Kimura2
  • Shahrokh F. Shariat1,15,16,17,18
18 affiliations
  1. 1Department of Urology, Comprehensive Cancer Center, Austrian Comprehensive Cancer Center Medical University of Vienna Vienna Austria
  2. 2Department of Urology The Jikei University School of Medicine Tokyo Japan
  3. 3Collegium Medicum – Faculty of Medicine WSB University Dąbrowa Górnicza Poland
  4. 4Department of Urology Medical University Center Hamburg‐Eppendorf Hamburg Germany
  5. 5Department of Urology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Okayama Japan
  6. 6Second Department of Urology Centre of Postgraduate Medical Education Warsaw Poland
  7. 7Division of Surgery and Interventional Sciences University College London London UK
  8. 8Cancer Prognostics and Health Outcomes Unit, Division of Urology University of Montréal Health Center Montréal QC Canada
  9. 9S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital The Chinese University of Hong Kong Hong Kong SAR Hong Kong
  10. 10Department of Urology, San Raffaele Hospital Vita‐Salute University Milan Italy
  11. 11Department of Cancer Epidemiology and Prevention Research, Cancer Research and Analytics, Cancer Care Alberta Alberta Health Services Calgary AB Canada
  12. 12Department of Oncology and Community Health Sciences, Cumming School of Medicine University of Calgary Calgary AB Canada
  13. 13Department of Epidemiology, Center for Public Health Medical University of Vienna Vienna Austria
  14. 14Channing Division of Network Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA USA
  15. 15Karl Landsteiner Institute of Urology and Andrology Vienna Austria
  16. 16Department of Urology Weill Cornell Medical College New York NY USA
  17. 17Department of Urology University of Texas Southwestern Medical Center Dallas TX USA
  18. 18Hourani Center for Applied Scientific Research Al‐Ahliyya Amman University Amman Jordan
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Abstract

Purpose: Although tobacco use and occupational exposures are established risk factors for urothelial cancer (UC), the influence of dietary factors remains uncertain. We conducted a systematic review to synthesize evidence from prospective cohort studies examining associations between dietary exposures and UC incidence.

Methods: A comprehensive literature search of MEDLINE, Embase, and Web of Science (May 2025) was performed to identify prospective studies evaluating dietary factors with UC incidence. The risk of bias was assessed using standard tools (CRD420251043101).

Results: From 6253 records screened, 32 prospective cohort studies were included, encompassing 2 277 677 participants. Investigated exposures included fluid intake (four studies, n = 562 038), coffee (four, n = 1 013 624), milk (three, n = 613 141), tea (three, n = 532 949), alcohol (three, n = 694 585), fruits (three, n = 597 753), vegetables (three, n = 555 685), protein (two, n = 469 339), fibre (two, n = 466 577), and cruciferous vegetables (two, n = 1 071 313). Only one study specifically assessed upper tract urothelial carcinoma (n = 80 388). Two studies suggested a borderline inverse association between high fluid intake and bladder cancer (BC) risk (upper 95% confidence interval >0.95), whereas two others found no such association. Three of four coffee studies reported no significant association after adjustment for smoking; one reported a modest increased risk. Fruit and vegetable intake showed modest inverse associations with BC risk in three studies. Most included studies were at moderate risk of bias, and residual confounding—particularly by smoking—remains a concern.

Conclusion: Available evidence does not support a strong or consistent association between dietary factors and BC incidence. Although a healthy diet is beneficial for overall well‐being, patients should be informed that dietary modifications alone are unlikely to meaningfully alter their BC risk.

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Cite

BibTeXRIS
BibTeX
@article{miyajima2026diet,
  title = {{Diet and risk of bladder cancer: a systematic review of epidemiological evidence}},
  author = {Keiichiro Miyajima and Marcin Miszczyk and Navid Roessler and Shota Inoue and Paweł Rajwa and Akihiro Matsukawa and Fumihiko Urabe and Keiichiro Mori and Takafumi Yanagisawa and Pierre I. Karakiewicz and Jeremy Yuen‐Chun Teoh and Alberto Briganti and Lin Yang and Eva Schernhammer and Takahiro Kimura and Shahrokh F. Shariat},
  journal = {Bju International},
  year = {2026},
  month = aug,
  doi = {10.1111/bju.70435},
  url = {https://doi.org/10.1111/bju.70435},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Diet and risk of bladder cancer: a systematic review of epidemiological evidence
AU  - Keiichiro Miyajima
AU  - Marcin Miszczyk
AU  - Navid Roessler
AU  - Shota Inoue
AU  - Paweł Rajwa
AU  - Akihiro Matsukawa
AU  - Fumihiko Urabe
AU  - Keiichiro Mori
AU  - Takafumi Yanagisawa
AU  - Pierre I. Karakiewicz
AU  - Jeremy Yuen‐Chun Teoh
AU  - Alberto Briganti
AU  - Lin Yang
AU  - Eva Schernhammer
AU  - Takahiro Kimura
AU  - Shahrokh F. Shariat
PY  - 2026
DA  - 2026/08/23
JO  - Bju International
DO  - 10.1111/bju.70435
UR  - https://doi.org/10.1111/bju.70435
AB  - Purpose: Although tobacco use and occupational exposures are established risk factors for urothelial cancer (UC), the influence of dietary factors remains uncertain. We conducted a systematic review to synthesize evidence from prospective cohort studies examining associations between dietary exposures and UC incidence.  Methods: A comprehensive literature search of MEDLINE, Embase, and Web of Science (May 2025) was performed to identify prospective studies evaluating dietary factors with UC incidence. The risk of bias was assessed using standard tools (CRD420251043101).  Results: From 6253 records screened, 32 prospective cohort studies were included, encompassing 2 277 677 participants. Investigated exposures included fluid intake (four studies, n = 562 038), coffee (four, n = 1 013 624), milk (three, n = 613 141), tea (three, n = 532 949), alcohol (three, n = 694 585), fruits (three, n = 597 753), vegetables (three, n = 555 685), protein (two, n = 469 339), fibre (two, n = 466 577), and cruciferous vegetables (two, n = 1 071 313). Only one study specifically assessed upper tract urothelial carcinoma (n = 80 388). Two studies suggested a borderline inverse association between high fluid intake and bladder cancer (BC) risk (upper 95% confidence interval >0.95), whereas two others found no such association. Three of four coffee studies reported no significant association after adjustment for smoking; one reported a modest increased risk. Fruit and vegetable intake showed modest inverse associations with BC risk in three studies. Most included studies were at moderate risk of bias, and residual confounding—particularly by smoking—remains a concern.  Conclusion: Available evidence does not support a strong or consistent association between dietary factors and BC incidence. Although a healthy diet is beneficial for overall well‐being, patients should be informed that dietary modifications alone are unlikely to meaningfully alter their BC risk.
SN  - 1464-4096
SN  - 1464-410X
ER  -