Abstract
Background: Upper tract urothelial carcinoma (UTUC) is a rare malignancy with limited epidemiological data from Central and Eastern Europe. This study aimed to evaluate long-term trends in UTUC incidence, mortality, and survival in Poland and to compare them with other European countries. Methods: Incidence and mortality data were acquired from Polish National Cancer Registry, Statistics Poland and European Cancer Information System. Age-standardized incidence and mortality rates were calculated using the European Standard Population (ESP 2013). Temporal trends were assessed using Joinpoint regression, and five-year relative survival was estimated with the Pohar-Perme method. Results: Our study demonstrated significantly higher incidence and mortality rates of UTUC across Europe compared to the initial observation period, consistent with the data from Poland. UTUC incidence increased in Poland between 2000 and 2017 (average annual percent change [AAPC] 5.6% in women and 9.9% in men), followed by a decline among women after 2017 (AAPC -1.3%). Mortality initially rose in both sexes but decreased in recent years, particularly in men (AAPC -5.47%). Renal pelvis cancer showed higher incidence and mortality than ureteral cancer. Compared with other European countries, Poland exhibited a smaller gap between incidence and mortality. Five-year relative survival improved over time, reaching 55-56% for renal pelvis cancer and up to 62% for ureteral cancer. Conclusions: UTUC incidence and mortality are rising in Europe, but Poland displays a distinctive epidemiological pattern. Strengthening national cancer registries and implementing centralized care protocols may improve disease management and reduce mortality.