Urothelial carcinoma of the renal pelvis and ureter is related to the same risk factors as urothelial carcinoma of the urinary bladder since the surface exposure to urinary carcinogens is the same. The more common occurrence of this tumor in the urinary bladder may be related to the size of that organ and the duration of exposure as an endpoint of “storage.” At least 50 % of urothelial carcinomas are related to smoking, probably the most significant contributory factor to the development of this malignancy in western countries. The influence of chemical carcinogens related to occupational exposure is also a major carcinogenic factor for which the influence is enhanced by smoking. Some of the upper tract urothelial carcinomas used to be related to the heavy use of phenacetin, an analgesic that was discontinued in the late 1980s. Some studies have shown that genetic factors may play a role in the initiation and progression of urothelial carcinoma related to the manner in which carcinogens are either further activated or detoxified.
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