Upper tract urothelial neoplasms: Incidence and survival during the last 2decades

Purpose: Upper tract urothelial cancer is rare but studies in the 1970s sho wed that its incidence was increasing. We evaluated national trends of the incidence and survival of upper tract urothelial neoplasms from 1973 to 199 6. Material and Methods: We obtained information on upper tract urothelial neo plasms from 1973 to 1996 from the National Cancer Institute Surveillance, E pidemiology and End Results program. To provide a time comparison we evalua ted upper tract urothelial cancer from 1973 to 1984 and 1985 to 1996. We al so calculated overall disease specific survival stratified by cancer stage, patient race and gender for the study period overall. Results: A total of 9,072 cases of upper tract urothelial cancer were ident ified in the Surveillance, Epidemiology and End Results program from 1973 t o 1996, including 5,379 of the renal pelvis and 3,678 of the ureter. Compar ing age adjusted annual incidence rates revealed an increase in ureteral ne oplasms from 0.69 to 0.73/100,000 person-years but no change in the inciden ce of renal pelvic tumors, while the rate of in situ neoplasms increased fr om 7.2% to 23.1%. Overall disease specific 5-year survival was significantl y different in regard to tumor stage (95.1% in situ, 88.9% localized, 62.6% regional and 16.5% distant lesions). Disease specific annual mortality was greater in black than in white individuals and in women than in men (7.4% versus 4.9% and 6.1% versus 4.4%, respectively). Conclusions: There appears to have been a slight increase in the national i ncidence of ureteral tumors in the last 23 years. Fortunately we also detec ted a slight improvement in the overall disease specific survival of patien ts with upper tract neoplasms.