NEW YORK (Reuters Health) - Young women with vulvar cancer tend to have
early-stage disease, smoke cigarettes, have a history of the human papilloma
virus and have vulvar dysplasia, according to results of a study published in
the June issue of the American Journal of Obstetrics and Gynecology. Most of
these risk factors are modifiable.
"Vulvar cancer is a relatively uncommon malignancy, occurring at a rate of 2.2
per 100,000 women per year," Dr. Patricia L. Judson, of the University of
Minnesota, Minneapolis, and colleagues note. However, "a recent Surveillance,
Epidemiology, and End Result Program-derived data review demonstrated that over
the past 28 years, the prevalence of in situ and invasive vulvar carcinoma has
increased," they add.
To determine whether those patients had different characteristics than others
with vulvar cancer, the researchers examined the demographic, surgicopathologic,
and outcome data for 56 women with squamous cell vulvar cancer who developed the
disease at age 45 years or younger.
Almost half of patients reported the presence of symptoms for less than 6 months
prior to diagnosis. The women had more tobacco exposure, and nearly 70% had a
history of vulvar intraepithelial neoplasia (VIN) or cervical intraepithelial
neoplasia (CIN). Patients who had advanced disease were less likely to have had
dysplasia, human papilloma virus (HPV), or VIN. Overall, 6.7% of patients were
immunocompromised.
Eighty percent of patients underwent modified radical vulvectomy with unilateral
or bilateral lymph node dissection. Of these, positive nodes were found in 18%
of patients. Compared to women with negative lymph nodes, those with positive
lymph nodes were more likely to have had cervical dysplasia or HPV (p = 0.04).
"If we could get women to modify these behaviors, the incidence of vulvar cancer
would be decreased," Dr. Judson told Reuters Health. "Women, and especially
young women, are unaware of vulvar cancer. They are also unaware that cigarette
smoking and exposure to the human papilloma virus increases their risk of
developing vulvar cancer. The HPV vaccinations will help to decrease the
incidence of this cancer."
Source : 2009 Reuters Limited
