2013 open access: Guidelines on Urothelial Carcinomas of the Upper Urinary Tract (LynchSyndrome)

Blogger's Note: UTUC = ureter, kidney, renal pelvis
  
"The major function of the renal pelvis is to act as a funnel for urine flowing to the ureter.
The renal pelvis is the location of several kinds of kidney cancer."

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European Association of Urology 2013

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 3.1 Epidemiology
Urothelial carcinomas are the fourth most common tumours after prostate (or breast), lung and colorectal cancer (4,5). They can be located in the lower urinary tract (bladder and urethra) or upper urinary tract
(pyelocaliceal cavities and ureter). Bladder tumours account for 90-95% of urothelial carcinomas and are the most common malignancy of the urinary tract (1,5). However, UTUCs are uncommon and account for
only 5-10% of urothelial carcinomas (4,6). The estimated annual incidence of UTUCs in western countries is about two new cases per 100,000 inhabitants. Pyelocaliceal tumours are about twice as common as ureteral tumours. In 17% of cases, concurrent bladder cancer is present (7). Recurrence of disease in the bladder occurs in 22-47% of UTUC patients (8-10), whereas recurrence in the contralateral upper tract is observed in 2-6% (11,12). The natural history of UTUCs differs from that of bladder cancer: 60% of UTUCs are invasive at
diagnosis compared with only 15-25% of bladder tumours (13,14). UTUCs have a peak incidence in people in their 70s and 80s, and they are three times more prevalent in men than in women (15,16).
There are familial/hereditary cases of UTUCs linked to hereditary non-polyposis colorectal carcinoma (HNPCC) (17). Among patients with UTUCs, HNPCC cases can be screened during a medical interview (18). There is a suspicion of hereditary UTUC if the patient is < 60 years of age, has a personal history of an
HNPCC-associated cancer, a first-degree relative aged < 50 years with HNPCC-associated cancer, or two first-degree relatives with HNPCC-associated cancer (18). These patients should undergo DNA sequencing to identify hereditary cancers that have been misclassified as sporadic cancers by insufficient clinical data (19)......