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Blood in urine

Seen blood in your urine? Get it checked

Most causes are not cancer, but blood in the urine should always be assessed by a doctor.

Man holding his lower abdomen with discomfort highlighted
Kidney Ureter Bladder Urethra
The urinary tract. Bleeding can start anywhere from the kidneys to the urethra.
Haematuria

Two kinds of blood in the urine

Visible haematuria turns urine pink, red or cola-coloured. Even a single episode should be checked by a doctor.

Non-visible haematuria is found only on a dipstick or lab test, often during a routine check. It is common and usually not caused by cancer, but it may need investigating depending on your age and other findings.

Some foods and medicines, such as beetroot or the antibiotic rifampicin, can colour urine red without any blood present.

Possible causes

Most blood in the urine is not cancer

Infection

Urinary tract infections often cause burning, frequency and blood in the urine.

Stones

Kidney or bladder stones can cause bleeding, often with pain in the side or back.

Prostate enlargement

An enlarged prostate can bleed, especially in older men.

Kidney conditions

Inflammation of the kidney's filters can show up as non-visible blood or protein.

Vigorous exercise

Long-distance running can cause temporary blood in the urine.

Cancer

Bladder and kidney cancers are less common causes, which is why unexplained bleeding is investigated.

Risk factors

Who is more likely to develop bladder cancer

  • Smoking, the biggest preventable cause. Cigarette smokers have up to four times the risk of people who have never smoked.
  • Being over 60
  • Being male
  • Past work with certain chemicals, such as in the dye, rubber and textile industries, metalworking, or jobs handling crude oil, petrol or combustion products. Cancer can develop decades after exposure.
  • Previous radiotherapy to the pelvis, for example for prostate cancer
  • Long-term irritation of the bladder from repeated urine infections, bladder stones or a long-term catheter
  • A parent, brother, sister or child who has had bladder cancer

Having a risk factor does not mean you will get bladder cancer, and many people diagnosed have none.

When to see your GP urgently

NICE guidance recommends an urgent suspected-cancer referral for:

  • people aged 45 or over with unexplained visible blood in the urine without a urine infection
  • people aged 45 or over with visible blood that persists or comes back after a urine infection has been treated
  • people aged 60 or over with unexplained non-visible blood and either pain passing urine or a raised white cell count on a blood test

It also suggests GPs consider a non-urgent referral for people aged 60 or over with urine infections that keep coming back or will not clear, with no clear cause.

If any of these apply to you, see your GP first. A private test can sit alongside an NHS referral but should not delay it.

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