What causes upper tract urothelial cancer?

The renal pelvis collects urine from the kidney, and the ureters carry urine to the bladder. Both are lined by urothelial cells. Cancer can begin when the controls that regulate cell growth and repair become altered. Lynch syndrome can increase the tendency to develop cancers because inherited changes affect DNA repair. Having Lynch syndrome does not mean cancer is certain, and many people with this cancer do not have a known inherited syndrome.

Tell a clinician about blood in the urine, urinary symptoms, previous cancers, and any close relatives with bowel, womb, urinary tract, or kidney-area cancers. The team may discuss urine tests, imaging, and examination of the urinary tract. If Lynch syndrome is a possibility, ask whether genetic counselling and testing would clarify your family risk and screening needs. Do not stop prescribed medicines or make major changes based on a suspected cause alone.

Arrange prompt medical assessment for visible blood in the urine, repeated blood found on testing, persistent side or back pain, or a change in urination that does not settle. Seek urgent help if bleeding is heavy, you cannot pass urine, or severe pain comes with vomiting, fever, or weakness.

Could my personal or family history suggest Lynch syndrome? What tests will check the renal pelvis and ureter? Should my relatives receive genetic advice? Which symptoms should prompt an urgent call?