**Core Concept**
Carcinoma of the bladder is a type of malignancy that arises from the epithelial lining of the urinary bladder. The majority of bladder cancers are transitional cell carcinomas (TCCs), which originate from the urothelial lining of the bladder.

**Why the Correct Answer is Right**
Most bladder cancers are associated with exposure to carcinogens, such as aromatic amines and polycyclic aromatic hydrocarbons (PAHs), which are found in tobacco smoke and certain industrial chemicals. These substances can cause DNA damage and mutations in the bladder epithelium, leading to the development of cancer. The most common genetic mutations involved in bladder cancer are p53 and Rb1.

**Why Each Wrong Option is Incorrect**
**Option A:** Carcinoma of the bladder is more common in women than men. **Incorrect**, as bladder cancer is approximately 3-4 times more common in men than women.

**Option B:** The most common symptom of bladder cancer is hematuria. **Incorrect**, while hematuria is a common symptom, it is not the most common presentation. Other symptoms, such as dysuria and frequency, are more frequent.

**Option C:** Carcinoma of the bladder is usually diagnosed at an early stage. **Incorrect**, as many cases of bladder cancer are diagnosed at an advanced stage, often due to delayed presentation.

**Clinical Pearl / High-Yield Fact**
The risk of bladder cancer can be reduced by avoiding exposure to tobacco smoke and certain industrial chemicals. Regular screening with urine cytology and cystoscopy can also help detect bladder cancer at an early stage.

**Correct Answer: D.**