Chen et al. [31] attributes the progressive increase in the high incidence of UTUC, especially among women, in part to the systematic replacement of traditionally used Chinese herbs with aristolochic acid based on aristolactam-DNA adducts and TP53 mutations, which are identical to those observed in UTUC associated with Balkan endemic nephropathy. The gene discussed is TP53; the disease is renal pelvis/ureter urothelial carcinoma.