Urological Malignancies in Young Adults: An Epidemiological and Clinicopathological Profile from a 10-Year Single-center Study

Abstract Introduction: Urological cancers are primarily diseases of older adults and are considered rare in younger age groups, often leading to delayed diagnosis and poorer outcomes. Understanding their epidemiology and clinicopathological profile in younger patients is essential for timely recognition and effective management. Materials and Methods: The institutional cancer database was retrospectively reviewed for patients aged 18–45 years diagnosed with histologically confirmed urological malignancies between 2013 and 2023. Data on demographics, risk factors, symptoms, tumor type, grade, stage, treatment, and outcomes were analyzed descriptively and compared with the published literature. Results: Of 1845 patients with urologic cancers treated at our institute, 142 (7.6%) met inclusion criteria. Most patients (42.3%) were aged 41–45 years. Flank pain (42.2%) and hematuria (33.8%) were the most frequent presentations, while 26.7% were detected incidentally. Smoking (25.4%) and alcohol use (21.1%) were the most common risk factors. Renal cell carcinoma (RCC) constituted 80.3% of cases, followed by bladder cancer (16.2%); other urologic cancers were rare. Radical nephrectomy (61.2%) was the predominant surgery elected for renal tumors, while most bladder tumors were managed with transurethral resection. Overall, 55.6% had no evidence of disease at last follow-up, 1.4% had recurrence, and 40.8% were lost to follow-up. About 3.5% of patients died of disease. Conclusion: Urological malignancies in young adults are not uncommon and often present late, with RCC predominating over bladder cancer. Hematuria or persistent flank pain in young adults should be thoroughly evaluated. Improved awareness, early imaging, and structured follow-up mechanisms are crucial to optimize outcomes.