To the Editor As academic urologic oncologists with an interest in Lynch syndrome (LS)-related genitourinary cancers, we read with great interest the article by Samadder et al1 quantifying the prevalence of Utah families fulfilling Amsterdam criteria and the risk of colonic and extracolonic malignant neoplasms. The authors used the Utah Population Database and linked it to the Utah Cancer Registry. They described finding a high rate of kidney (standardized morbidity ratio [SMR], 3.22) and urinary bladder (SMR, 1.62) cancers in first-degree relatives of Amsterdam criteria pedigrees. The data are informative and we congratulate the authors on this effort, yet we have one concern.