Urol. praxi. 2026;27(3):139-143 | DOI: 10.36290/uro.2026.013

Incidence of second primary malignancies after primary oncological treatment of bladder cancer

MUDr. Anna Žaloudeková, MUDr. Lucia Ježíková, prof. MUDr. Tomáš Büchler, Ph.D.

Onkologická klinika, 2. LF UK a Fakultní nemocnice Motol a Homolka, Praha

Second primary malignancies represent a significant late complication of cancer treatment, with a cumulative incidence of approximately 15% over 20 years of follow-up and a several-fold higher risk compared to the general population. Patients after oncological treatment for bladder cancer, which is a common malignancy with a growing number of long-term survivors, constitute a particularly high-risk group in this regard, in whom late treatment-related complications are of major clinical importance. The most frequently observed secondary malignancies are smoking-related tumors, particularly lung and laryngeal cancer, followed by prostate, colorectal, and renal malignancies. An increased incidence has also been reported for hematological malignancies (notably chronic lymphocytic leukemia), skin cancers, and thyroid cancer. Risk is the highest within the first five years after the initial cancer diagnosis. The main risk factors include male sex, older age, smoking, and treatment-related factors, especially radiotherapy. In contrast, no significant increase in risk has been clearly demonstrated for cisplatin-based chemotherapy or intravesical BCG therapy. A shared aetiology, particularly tobacco exposure, also plays an important role. Therefore, patients treated for bladder cancer require long-term follow-up aimed not only at detecting recurrence but also at the early diagnosis of secondary malignancies and the implementation of effective preventive strategies.

Keywords: second primary cancer, bladder cancer, late effects of cancer treatment.

Received: April 15, 2026; Revised: April 30, 2026; Accepted: May 4, 2026; Published: October 21, 2026  Show citation