Vulvar cancer is a
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
of the
vulva
The vulva (plural: vulvas or vulvae; derived from Latin for wrapper or covering) consists of the external female sex organs. The vulva includes the mons pubis (or mons veneris), labia majora, labia minora, clitoris, vestibular bulbs, vulv ...
, the outer portion of the female genitals.
It most commonly affects the
labia majora
The labia majora (singular: ''labium majus'') are two prominent longitudinal cutaneous folds that extend downward and backward from the mons pubis to the perineum. Together with the labia minora they form the labia of the vulva.
The labia majo ...
.
[ Less often, the ]labia minora
The labia minora (Latin for 'smaller lips', singular: ''labium minus'', 'smaller lip'), also known as the inner labia, inner lips, vaginal lips or nymphae are two flaps of skin on either side of the human vaginal opening in the vulva, situated b ...
, clitoris, or vaginal glands are affected.[ Symptoms include a lump, itchiness, changes in the skin, or bleeding from the vulva.][
Risk factors include ]vulvar intraepithelial neoplasia
Vulvar intraepithelial neoplasia (VIN) refers to particular changes that can occur in the skin that covers the vulva. VIN is an intraepithelial neoplasia, and can disappear without treatment. VINs are benign but if the changes become more severe, ...
(VIN), HPV infection, genital warts
Genital warts are a sexually transmitted infection caused by certain types of human papillomavirus (HPV). They are generally pink in color and project out from the surface of the skin. Usually they cause few symptoms, but can occasionally be pai ...
, smoking, and many sexual partners.[ Most vulvar cancers are ]squamous cell cancer
Squamous-cell carcinomas (SCCs), also known as epidermoid carcinomas, comprise a number of different types of cancer that begin in squamous cells. These cells form on the surface of the skin, on the lining of hollow organs in the body, and on the ...
s. Other types include adenocarcinoma, melanoma, sarcoma
A sarcoma is a malignant tumor, a type of cancer that arises from transformed cells of mesenchymal ( connective tissue) origin. Connective tissue is a broad term that includes bone, cartilage, fat, vascular, or hematopoietic tissues, and sar ...
, and basal cell carcinoma
Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raise ...
. Diagnosis is suspected based on physical examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...
and confirmed by tissue biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a disea ...
.[ Routine screening is not recommended.][
Prevention may include HPV vaccination.] Standard treatments may include surgery, radiation therapy
Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radi ...
, chemotherapy
Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs ( chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemothe ...
, and biologic therapy.[ Vulvar cancer newly affected about 44,200 people and resulted in 15,200 deaths globally in 2018.] In the United States, it newly occurred in about 6,070 people with 1,280 deaths a year.[ Onset is typically after the age of 45.][ The ]five-year survival rate
The five-year survival rate is a type of survival rate for estimating the prognosis of a particular disease, normally calculated from the point of diagnosis. Lead time bias from earlier diagnosis can affect interpretation of the five-year surviva ...
for vulvar cancer is around 71% as of 2015. Outcomes, however, are affected by whether spread has occurred to lymph nodes
A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that inclu ...
.[
]
Signs and symptoms
The signs and symptoms can include:
*Itching
Itch (also known as pruritus) is a Wikt:sensation, sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to be classified as any one type of Sensory system, sensory experience. Itch has many similarities to pain, ...
, burn, or bleeding
Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
on the vulva that does not go away.
*Changes in the color of the skin of the vulva, so that it looks redder or whiter than is normal.
*Skin changes in the vulva, including what looks like a rash or warts.
*Sores, lumps, or ulcer
An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
s on the vulva that do not go away.
*Pain in the pelvis, especially during urination
Urination, also known as micturition, is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, ...
or sex
Sex is the trait that determines whether a sexually reproducing animal or plant produces male or female gametes. Male plants and animals produce smaller mobile gametes (spermatozoa, sperm, pollen), while females produce larger ones ( ova, of ...
.
Typically, a lesion presents in the form of a lump or ulcer
An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...
on the labia majora
The labia majora (singular: ''labium majus'') are two prominent longitudinal cutaneous folds that extend downward and backward from the mons pubis to the perineum. Together with the labia minora they form the labia of the vulva.
The labia majo ...
and may be associated with itching, irritation, local bleeding or discharge, in addition to pain with urination or pain during sexual intercourse. The labia minora
The labia minora (Latin for 'smaller lips', singular: ''labium minus'', 'smaller lip'), also known as the inner labia, inner lips, vaginal lips or nymphae are two flaps of skin on either side of the human vaginal opening in the vulva, situated b ...
, clitoris, perineum
The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), includi ...
and mons are less commonly involved. Due to modesty or embarrassment, people may put off seeing a doctor.
Melanomas tend to display the typical asymmetry, uneven borders and dark discoloration as do melanomas in other parts of the body.
Adenocarcinoma can arise from the Bartholin gland and present with a painful lump.
Causes
Two main pathophysiological pathways are currently understood to contribute to development of vulvar cancer—human papillomavirus (HPV) infection and chronic inflammation or autoimmunity affecting the vulvar area.
HPV DNA can be found in up to 87% of vulvar intraepithelial neoplasia (VIN) and 29% of invasive vulvar cancers; HPV 16 is the most commonly detected subtype in VIN and vulvar cancer, followed by HPV 33 and HPV 18. VIN is a superficial lesion of the skin
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation.
Other animal coverings, such as the arthropod exoskeleton, have different de ...
that has not invaded the basement membrane—or a pre-cancer. VIN may progress to carcinoma in situ
Carcinoma ''in situ'' (CIS) is a group of abnormal cells. While they are a form of neoplasm, there is disagreement over whether CIS should be classified as cancer. This controversy also depends on the exact CIS in question (i.e. cervical, skin, bre ...
and, eventually, squamous cell cancer.
Chronic inflammatory conditions of the vulva that may be precursors to vulvar cancer include lichen sclerosus
Lichen sclerosus (LS) is a chronic, inflammatory skin disease of unknown cause which can affect any body part of any person but has a strong preference for the genitals (penis, vulva) and is also known as balanitis xerotica obliterans (BXO) when ...
, which can predispose to differentiated VIN.
Risk factors
Risk factors for vulvar cancer are largely related to the causal pathways above, involving exposure or infection with the HPV virus and/or acquired or innate auto-immunity.
* Increasing age
*History of vulvar or cervical intraepithelial neoplasia
*Increased number of male sexual partners
*Prior history pre-invasive or invasive cervical cancer
* History of cigarette smoking
* Infection with human immunodeficiency virus (HIV)
*Vulvar lichen sclerosus
* Immunodeficiency syndromes
* Northern European ancestry
Diagnosis
Examination of the vulva is part of the gynecologic evaluation and should include a thorough inspection of the perineum
The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), includi ...
, including areas around the clitoris and urethra, and palpation of the Bartholin's glands.
The exam may reveal an ulceration, lump or mass in the vulvar region. Any suspicious lesions need to be sampled, or biopsied. This can generally be done in an office setting under local anesthesia
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It ...
. Small lesions can be removed under local anesthesia as well.
Additional evaluation may include a chest X-ray, an intravenous pyelogram
Pyelogram (or pyelography or urography) is a form of imaging of the renal pelvis and ureter.
Types include:
* Intravenous pyelogram – In which a contrast solution is introduced through a vein into the circulatory system.
* Retrograde pyelogram ...
, cystoscopy
Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope.
The urethra is the tube that carries urine from the bladder to the outside of the body.
The cystoscope has lenses like a telescope or microscop ...
or proctoscopy, as well as blood counts and metabolic assessment.
Types
Depending on the cellular origin, different histologic cancer subtypes may arise in vulvar structures.
Squamous cell carcinoma
A recent analysis of the Surveillance, Epidemiology and End Results (SEER) registry of the US National Cancer Institute
The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
has shown that squamous cell carcinoma accounts for approximately 75% of all vulvar cancers. These lesions originate from epidermal
The epidermis is the outermost of the three layers that comprise the skin, the inner layers being the dermis and hypodermis. The epidermis layer provides a barrier to infection from environmental pathogens and regulates the amount of water relea ...
squamous cells, the most common type of skin cell. Carcinoma-in-situ is a precursor lesion of squamous cell cancer that does not invade through the basement membrane. There are two types of precursor lesions:
* Usual-type vulvar intraepithelial neoplasia
Vulvar intraepithelial neoplasia (VIN) refers to particular changes that can occur in the skin that covers the vulva. VIN is an intraepithelial neoplasia, and can disappear without treatment. VINs are benign but if the changes become more severe, ...
(uVIN), which is associated with human papillomavirus (HPV) and often affects younger women. This precursor lesion progresses to basaloid or warty squamous cell carcinoma in approximately 6%.
* Differentiated vulvar intraepithelial neoplasia (dVIN), which is associated with chronic skin conditions including lichen sclerosus
Lichen sclerosus (LS) is a chronic, inflammatory skin disease of unknown cause which can affect any body part of any person but has a strong preference for the genitals (penis, vulva) and is also known as balanitis xerotica obliterans (BXO) when ...
and lichen planus
Lichen planus (LP) is a chronic inflammatory and immune-mediated disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, and is only named that because it looks like one. It is characterized by polygonal, fla ...
and typically affects older women. This lesion progresses to keratinizing squamous cell carcinoma in approximately 33%.
Squamous lesions tend to arise in a single site and occur most commonly in the vestibule. They grow by local extension and spread via the local lymph system
The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system, and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphatic or lymphoi ...
. The lymphatics of the labia drain to the upper vulva and mons pubis
In human anatomy, and in mammals in general, the ''mons pubis'' or pubic mound (also known simply as the mons, and known specifically in females as the ''mons Venus'' or ''mons veneris'') is a rounded mass of fatty tissue found over the pubic sym ...
, then to both superficial and deep inguinal and femoral lymph nodes. The last deep femoral node is called the Cloquet's node
Inguinal lymph nodes are lymph nodes in the human groin. Located in the femoral triangle of the inguinal region, they are grouped into superficial and deep lymph nodes. The superficial have three divisions: the superomedial, superolateral, and i ...
. Spread beyond this node reaches the lymph nodes of the pelvis. The tumor may also invade nearby organs such as the vagina
In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen ...
, urethra
The urethra (from Greek οὐρήθρα – ''ourḗthrā'') is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both females and males. In human females and other primates, the urethra c ...
, and rectum and spread via their lymphatics.
A verrucous carcinoma
Verrucous carcinoma (VC) is an uncommon variant of squamous cell carcinoma. This form of cancer is often seen in those who chew tobacco or use snuff orally, so much so that it is sometimes referred to as "Snuff dipper's cancer".
Signs and symp ...
of the vulva is a rare subtype of squamous cell cancer and tends to appear as a slowly growing wart
Warts are typically small, rough, hard growths that are similar in color to the rest of the skin. They typically do not result in other symptoms, except when on the bottom of the feet, where they may be painful. While they usually occur on the ...
. Verrucous vulvar cancers tend to have a good overall prognosis, as these lesions hardly ever spread to regional lymph nodes or metastasize.
Basal cell carcinoma
Basal cell carcinoma
Basal-cell carcinoma (BCC), also known as basal-cell cancer, is the most common type of skin cancer. It often appears as a painless raised area of skin, which may be shiny with small blood vessels running over it. It may also present as a raise ...
account for approximately 8% of all vulvar cancers. It typically affects women in the 7th and 8th decade of life. These tend to be slow-growing lesions on the labia majora but can occur anywhere on the vulva. Their behavior is similar to basal cell cancers in other locations. They often grow locally and have low risk for deep invasion or metastasis.
Treatment involves local excision, but these lesions have a tendency to recur if not completely removed.
Melanoma
Melanoma is the third most common type and accounts for 6% of all vulvar cancers. These lesions arise from melanocytes, the cells that give skin color. The median age at diagnosis is 68 years; however, an analysis of the Surveillance, Epidemiology and End Results (SEER) registry of the US National Cancer Institute
The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
has shown that it has been diagnosed in girls as young as 10 years and women up to 107 years.
The underlying biology of vulvar melanoma differs significantly from skin melanomas and mutational analyses have shown only 8% harbor a BRAF mutation compared to 70% of skin melanomas. KIT mutations, however are significantly more common in vulvar melanoma. This has a direct impact on the medical treatment of vulvar melanomas: BRAF-inhibitors that are commonly used in the treatment of skin melanomas, play a minor role in vulvar melanomas. However, vulvar melanomas frequently express PD-L1
Programmed death-ligand 1 (PD-L1) also known as cluster of differentiation 274 (CD274) or B7 homolog 1 (B7-H1) is a protein that in humans is encoded by the ''CD274'' gene.
Programmed death-ligand 1 (PD-L1) is a 40kDa type 1 transmembrane protei ...
and checkpoint inhibitor
Checkpoint inhibitor therapy is a form of cancer immunotherapy. The therapy targets immune checkpoints, key regulators of the immune system that when stimulated can dampen the immune response to an immunologic stimulus. Some cancers can protect the ...
s (including CTLA-4 inhibitors and PD-1 inhibitors) are effective in the treatment of advanced-stage vulvar melanoma. In recurrent melanoma, tyrosine kinase inhibitors
A tyrosine kinase inhibitor (TKI) is a pharmaceutical drug that inhibits tyrosine kinases. Tyrosine kinases are enzymes responsible for the activation of many proteins by signal transduction cascades. The proteins are activated by adding a phosp ...
may be used in those patients with a KIT mutation.
Based on histology
Histology,
also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vi ...
, there are different subtypes of vulvar melanoma: superficial spreading, nodular, acral lentigous and amelanotic melanoma. Vulvar melanomas are unique in that they are staged using the AJCC cancer staging for melanoma instead of the FIGO staging system.
Diagnosis of vulvar melanoma is often delayed and approximately 32% of women already have regional lymph node involvement or distant metastases at the time of diagnosis. Lymph node metastases and high mitotic count are indicators of poor outcome. The overall prognosis is poor and significantly worse than in skin melanomas: The median overall survival is 53 months.
Bartholin gland carcinoma
The Bartholin gland is a rare malignancy and usually occurs in women in their mid-sixties.
Other lesions
Other forms of vulvar cancer include invasive Extramammary Paget's disease
Extramammary Paget's Disease (EMPD) is a rare and slow-growing malignancy which occurs within the epithelium and accounts for 6.5% of all Paget's disease. The clinical presentation of this disease is similar to the characteristics of mammary Pa ...
, adenocarcinoma (of the Bartholin glands, for example) and sarcoma
A sarcoma is a malignant tumor, a type of cancer that arises from transformed cells of mesenchymal ( connective tissue) origin. Connective tissue is a broad term that includes bone, cartilage, fat, vascular, or hematopoietic tissues, and sar ...
.
Staging
Anatomical staging supplemented preclinical staging starting in 1988. FIGO's revised TNM classification system uses tumor size (T), lymph node involvement (N) and presence or absence of metastasis (M) as criteria for staging. Stages I and II describe the early stages of vulvar cancer that still appear to be confined to the site of origin. Stage III cancers include greater disease extension to neighboring tissues and inguinal lymph nodes on one side. Stage IV indicates metastatic disease to inguinal nodes on both sides or distant metastases.
Differential diagnosis
Other cancerous lesions in the differential diagnosis include Paget's disease of the vulva and vulvar intraepithelial neoplasia (VIN). Non-cancerous vulvar diseases include lichen sclerosus
Lichen sclerosus (LS) is a chronic, inflammatory skin disease of unknown cause which can affect any body part of any person but has a strong preference for the genitals (penis, vulva) and is also known as balanitis xerotica obliterans (BXO) when ...
, squamous cell hyperplasia, and vulvar vestibulitis. A number of diseases cause infectious lesions including herpes genitalis
Genital herpes is an infection by the herpes simplex virus (HSV) of the genitals. Most people either have no or mild symptoms and thus do not know they are infected. When symptoms do occur, they typically include small blisters that break open ...
, human papillomavirus
Human papillomavirus infection (HPV infection) is caused by a DNA virus from the ''Papillomaviridae'' family. Many HPV infections cause no symptoms and 90% resolve spontaneously within two years. In some cases, an HPV infection persists and res ...
, syphilis, chancroid, granuloma inguinale
Granuloma inguinale is a bacterial disease caused by ''Klebsiella granulomatis'' (formerly known as ''Calymmatobacterium granulomatis'') characterized by genital ulcers. It is endemic in many less-developed regions. It is also known as donovano ...
, and lymphogranuloma venereum
Lymphogranuloma venereum (LGV; also known as climatic bubo, Durand–Nicolas–Favre disease, poradenitis inguinale, lymphogranuloma inguinale, and strumous bubo) is a sexually transmitted disease caused by the invasive serovars L1, L2, L2a, L2 ...
.
Treatment
Surgery is a mainstay of therapy depending on anatomical staging and is usually reserved for cancers that have not spread beyond the vulva. Surgery may involve a wide local excision (excision of the tumor with a safety-margin of healthy tissue, that ensures complete removal of the tumor), radical partial vulvectomy, or radical complete vulvectomy with removal of vulvar tissue, inguinal and femoral lymph nodes. In cases of early vulvar cancer, the surgery may be less extensive and consist of wide excision or a simple vulvectomy. Surgery is significantly more extensive when the cancer has spread to nearby organs such as the urethra, vagina, or rectum. Complications of surgery include wound infection, sexual dysfunction, edema and thrombosis
Thrombosis (from Ancient Greek "clotting") is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system. When a blood vessel (a vein or an artery) is injured, the body uses platelets (t ...
, as well as lymphedema
Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns interstitial fl ...
secondary to dissected lymph nodes.
Sentinel lymph node
The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasiz ...
(SLN) dissection is the identification of the main lymph node(s) draining the tumor, with the aim of removing as few nodes as possible, decreasing the risk of adverse effects. Location of the sentinel node(s) may require the use of technetium(99m)-labeled nano-colloid, or a combination of technetium and 1% isosulfan blue dye, wherein the combination may reduce the number of women with "'missed"' groin node metastases compared with technetium only.
Radiation therapy
Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Radi ...
may be used in more advanced vulvar cancer cases when disease has spread to the lymph nodes and/or pelvis. It may be performed before or after surgery. In early vulvar cancer, primary radiotherapy to the groin results in less morbidity but may be linked with a higher risk of groin recurrence and reduced survival compared to surgery. Chemotherapy
Chemotherapy (often abbreviated to chemo and sometimes CTX or CTx) is a type of cancer treatment that uses one or more anti-cancer drugs ( chemotherapeutic agents or alkylating agents) as part of a standardized chemotherapy regimen. Chemothe ...
is not usually used as primary treatment but may be used in advanced cases with spread to the bones, liver or lungs. It may also be given at a lower dose together with radiation therapy. Checkpoint inhibitor
Checkpoint inhibitor therapy is a form of cancer immunotherapy. The therapy targets immune checkpoints, key regulators of the immune system that when stimulated can dampen the immune response to an immunologic stimulus. Some cancers can protect the ...
s may be given in melanoma of the vulva.
There is no significant difference in overall survival or treatment‐related adverse effects in women with locally advanced vulval cancer when comparing primary chemoradiation or neoadjuvant chemoradiation with primary surgery. There is a need for good quality studies comparing various primary treatments.
Women with vulvar cancer should have routine follow-up and exams with their oncologist, often every three months for the first 2–3 years after treatment. They should not have routine surveillance imaging to monitor the cancer unless new symptoms appear or tumor markers
A tumor marker is a biomarker found in blood, urine, or body tissues that can be elevated by the presence of one or more types of cancer. There are many different tumor markers, each indicative of a particular disease process, and they are used ...
begin rising. Imaging without these indications is discouraged because it is unlikely to detect a recurrence or improve survival and is associated with its own side effects and financial costs.
Prognosis
Overall, five-year survival rates for vulvar cancer are around 78% but may be affected by individual factors including cancer stage, cancer type, patient age and general medical health. Five-year survival is greater than 90% for patients with stage I lesions but decreases to 20% when pelvic lymph nodes are involved. Lymph node involvement is the most important predictor of prognosis.
Prognosis depends on the stage of cancer, which refers the amount and spread of cancer in the body. The stages are broken into four categories. Stage one also called "localized" and is when the cancer is limited to one part of the body. This has the highest survival rate of 59%. When the cancer starts to spread this is referred to "distant" or "regional", this stage usually involves the cancer being spread to the lymph nodes. This survival rate is 29%. The third stage is when the cancer has metastasized and spread throughout the body, this is the lowest survival rate of 6%. When vulvar cancer is caught early that is when the survival rate is at its highest.
Epidemiology
Vulvar cancer newly affected about 44,200 people and resulted in 15,200 deaths globally in 2018.[
Vulvar cancer can be split up into two types. One starts as an infection by human papillomavirus, which leads to vulvar intraepithelial neoplasia (VIN) and potentially on to vulvar cancer.] This is most common in younger women, predominantly under the age of 40. The second type is vulvar non-neoplastic epithelial disorders (VNED). This is most common in older women, due to the increased risk for developing cellular atypia which in turn leads to cancer.
United Kingdom
Vulvar cancer causes less than 1% of all cancer cases and deaths but around 6% of all gynecologic cancers diagnosed in the UK. Around 1,200 women were diagnosed with the disease in 2011, and 400 women died in 2012. In the United Kingdom 7 out of 10 vulval cancer patients have major surgical resection as part of their cancer treatment. 22% of patients use radiotherapy and only 7% use chemotherapy as a treatment plan. There are very high survival rates, patients diagnosed with vulvar cancer have an 82% of living more than one year, a 64% chance of living at least 5 years and a 53% chance of living ten or more years. The rate of survival increases dependent on age of patient and the stage the cancer was found in.
United States
In the United States, it newly occurred in about 6,070 people with 1,280 deaths a year.[ It makes up about 0.3% of new cancer cases,][ and 5% of gynecologic cancers in the United States.] Vulvar cancer cases have been rising in the United States at an increase of 0.6% each year for the past ten years.
References
External links
Vulvar Cancer Treatment (PDQ®)–Health Professional Version
Information from the US National Cancer Institute
The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
* Review article for general practitioners.
{{DEFAULTSORT:Vulvar Cancer
Gynaecological cancer
Papillomavirus-associated diseases
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