Epidemiology and risk factors for upper urinary urothelial cancers

Abstract

Urothelial carcinoma is a disease characterized by multiplicity, recurrence, and multifocality. Whilst around 5 % of tumors are in the upper tract, as with other human cancers, the study of unusual tumors within a spectrum can reveal insights into disease etiology and biology. Here we review genetic and acquired factors involved in the formation of upper tract urothelial carcinoma. This tumor is the main urological cancer found in Lynch syndrome. Around 10 % of sporadic tumors have similar molecular mechanisms to cancers arising within this most common cancer syndrome. With regard to acquired factors, we report data implicating aristolochic acid ingestion (through contaminated wheat or Chinese medicines) and tobacco smoking. Finally, we review risk factors for developing upper tract urothelial tumors, following treatment for bladder cancer.