 Bladder cancer is any of several types of cancer arising from the tissues of the urinary bladder. It is a disease in which cells grow abnormally and have the potential to spread to other parts of the body. Symptoms include blood in the urine, pain with urination, and low back pain. Risk factors for bladder cancer include smoking, family history, prior radiation therapy, frequent bladder infections, and exposure to certain chemicals. The most common type is transitional cell carcinoma. Other types include squamous cell carcinoma and adenocarcinoma. Diagnosis is typically by cystoscopy with tissue biopsies. Staging of the cancer is typically determined by medical imaging such as CT scan and bone scan. Treatment depends on the stage of the cancer. It may include some combination of surgery, radiation therapy, chemotherapy, or immunotherapy. Surgical options may include transurethal reception, partial or complete removal of the bladder, or urinary diversion. Typical 5-year survival rates in the United States are 77%. Bladder cancer, as of 2015, affects about 3.4 million people globally with 430,000 new cases a year. In 2015 it resulted in 188,000 deaths. Age of onset is most often between 65 and 85 years of age. Two males are more often affected than females. In the United States, in 2018, 81,000 cases and 17,000 deaths are expected making it the sixth most common type of cancer in the region.