Materiały źródłowe

• #1 Vulvar Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/1001/p1269.html

  Vulvar cancer was reported in 3,200 women in 1998, resulting in 800 deaths. Recent evidence suggests that vulvar cancer comprises two separate diseases. The first type may develop from vulvar intraepithelial neoplasia caused by human papillomavirus infection and is increasing in prevalence among young women. The second type, which more often afflicts older women, may develop from vulvar non-neoplastic epithelial disorders as a result of chronic inflammation (the itch-scratchlichen sclerosus hypothesis). […] In 1998, approximately 3,200 women in the United States developed cancer of the vulva, and 800 women died of the disease. Overall, vulvar cancer is relatively uncommon, accounting for 3 to 5 percent of female genital-tract malignancies. […] Over the past decade, the prevalence of VIN in young women has increased significantly. VIN is clearly a premalignant finding and is associated with HPV infection, particularly subtypes 16 and 18.

• #2 Vulvar and vaginal cancer – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vulvar-and-vaginal-cancer/

  Vulvar cancer is a rare carcinoma that predominantly occurs after menopause. Major risk factors include HPV infection, smoking, vulvar intraepithelial neoplasia, and cervical intraepithelial neoplasia. […] Incidence: rare (0.7% of female cancers). […] HPV-related vulvar tumors have a higher prevalence of multifocal lesions and concurrent cervical neoplasia compared to HPV-negative tumors. […] All suspected vulvar cancer requires specialist consultation (e.g., gynecologic or surgical oncologist). […] Biopsy of all suspicious lesions with histological analysis and tumor grading is necessary for diagnostic confirmation. […] FIGO or TNM classification: helps establish prognosis and appropriate management. […] HPV vaccination reduces recurrence rates after surgical therapy. […] There are no screening tests for vulvar or vaginal cancers in asymptomatic individuals.

• #3 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #4 Vulvar Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567798/

  Vulvar cancer represents 0.3% of all new cancer cases in the United States. Squamous cell carcinoma is the most common type, usually diagnosed at ages 65 to 74. Risk factors include increasing age, HPV infection, smoking, inflammatory conditions of the vulva, prior pelvic radiation, and immunodeficiency. […] According to the Surveillance, Epidemiology, and End Results (SEER) Program, vulvar cancer represents 0.3% of all new cancer cases annually at a rate of 2.6 per 100,000 women per year in the United States. […] SEER data supports that vulvar cancer is most commonly diagnosed at ages 65 to 74, with the median age at diagnosis of 69 years. The data notes that sixty percent of diagnoses are localized and exhibit an 85% five-year survival. […] Vulvar SCC represents 90% of all vulvar cancers and typically develops by one of two pathways.

• #5 Vulvar Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/vulva.html

  Estimated New Cases in 2025 7,480. […] % of All New Cancer Cases 0.4%. […] Estimated Deaths in 2025 1,770. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of vulvar cancer was 2.6 per 100,000 women per year. […] Vulvar cancer represents 0.4% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 7,480 new cases of vulvar cancer and an estimated 1,770 people will die of this disease. […] Vulvar cancer is rare. It is more common among women with a medical history of vulvar intraepithelial neoplasia, human papillomavirus (HPV) infection, or genital warts. […] For vulvar cancer, death rates increase with age. The death rate was 0.6 per 100,000 women per year based on 20192023, age-adjusted. […] The percent of vulvar cancer deaths is highest among women aged 7584.

• #6 Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-cancer-epidemiology-diagnosis-histopathology-and-treatment

  Vulvar cancer is less common than other gynecologic malignancies, including uterine corpus, ovarian, and cervical cancer; in the United States, vulvar cancer is also less common than vaginal cancer. Squamous cell carcinoma is the most common histologic type of vulvar cancer, comprising at least 75 percent of cases. Other histologies include melanoma, basal cell carcinoma, Bartholin gland adenocarcinoma, sarcoma, and Paget disease. […] Human papillomavirus (HPV) infection is associated with the majority of vulvar squamous cell carcinomas. In addition, vulvar lichen sclerosus is associated with an increased risk of vulvar cancers. […] In the United States, there are approximately 7480 new cases of and 1770 deaths from vulvar cancer each year. […] Incidence rates by race or ethnicity in the United States from 2017 to 2021 were: Non-Hispanic White (3.1 per 100,000 persons), non-Hispanic Black (1.9), Asian American/Pacific Islander (1), Hispanic American (1.9), and non-Hispanic American Indian (3). In the United States, some data suggest that Black patients present with vulvar cancer at a younger age and have an increased probability of distant spread, which is a consistent finding across the different tumor models.

• #7 Vulvar Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/vulva.html?statfacts_page=vulva.html&x=9&y=20

  Estimated New Cases in 2025 7,480. […] % of All New Cancer Cases 0.4%. […] Estimated Deaths in 2025 1,770. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of vulvar cancer was 2.6 per 100,000 women per year. […] Vulvar cancer represents 0.4% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 7,480 new cases of vulvar cancer and an estimated 1,770 people will die of this disease. […] Vulvar cancer is rare. It is more common among women with a medical history of vulvar intraepithelial neoplasia, human papillomavirus (HPV) infection, or genital warts. […] For vulvar cancer, death rates increase with age. The death rate was 0.6 per 100,000 women per year based on 2019-2023, age-adjusted. […] Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new vulvar cancer cases have been rising on average 0.7% each year over 2013-2022. Age-adjusted death rates have been rising on average 2.1% each year over 2014-2023.

• #8 Key Statistics for Vulvar Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/vulvar-cancer/about/key-statistics.html

  About 7,480 cancers of the vulva will be diagnosed. […] About 1,770 women will die of this cancer. […] In the United States, vulvar cancer accounts for about 0.7% of all cancers in women. Women have about a 1 in 333 chance of developing vulvar cancer at some point during their life.

• #9 Vulvar Cancer – Ovarian Cancer Research Alliance

  https://ocrahope.org/for-patients/gynecologic-cancers/vulvar-cancer/

  Vulvar cancer comprises about 6% of gynecologic cancer diagnoses. […] There is no standard screening tool for vulvar cancer. […] Close surveillance can help identify evidence of new lesions or recurrence early, which improves outcomes. […] The overall five-year relative survival rate for those diagnosed with vulvar cancer is 71%. […] The American Cancer Society estimates that in 2024 in the U.S., about 6,900 cancers of the vulva will be diagnosed, and 1,630 women will die of vulvar cancer. Vulvar cancer accounts for 1% of cancers in women, and women have about a 1 in 133 chance of developing vulvar cancer in their lifetime.

• #10 Vulvar and vaginal cancer epidemiology and molecular pathogenesis | PPT

  https://www.slideshare.net/slideshow/vulvar-and-vaginal-cancer-epidemiology-and-molecular-pathogenesis/47789486

  Overall 5 years survival rate in USA is 71.2% Based on data from SEER 18 2005-2011 The earlier vulvar cancer is diagnosed, the better chance a person has of surviving five years after being diagnosed. For vulvar cancer, 59.2% are diagnosed at the local stage. The 5-year survival for localized vulvar cancer is 85.8%. […] Primary carcinomas of the vagina represent 12% of malignant neoplasms of the female genital tract. In the United States, it is estimated that there will be 3,170 new cases diagnosed in 2014, and 880 deaths from the disease. […] Unlike cervical cancer, more than 50% of patients are diagnosed in the seventh, eighth, and ninth decades of life. Squamous cell carcinoma is the most common vaginal cancer. The mean age of the patients is approximately 67 years, although the disease occasionally is seen in the third and fourth decades of life. About 80% of patients are older than 50 years. […] Over 90% of high-grade VAIN 23 lesions and 70% of vaginal cancers are associated with HPV infections. HPVs 16 and 18 are associated with over 60% of high-grade VAIN and 40% of low-grade VAIN.

• #11 Vulvar Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/vulva.html

  Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new vulvar cancer cases have been rising on average 0.7% each year over 20132022. Age-adjusted death rates have been rising on average 2.1% each year over 20142023.

• #12 Vulvar and vaginal cancer epidemiology and molecular pathogenesis | PPT

  https://www.slideshare.net/slideshow/vulvar-and-vaginal-cancer-epidemiology-and-molecular-pathogenesis/47789486

  1. Incidence Constitutes 5% of all the malignancies of female genital tract 0.6% of female cancer Estimated new cases and deaths from vulval cancer in the United States in 2015 New cases: 5150 Deaths: 1080 Rare malignancy (28th) in the United States and accounts for 0.3% of all new cancers. Cancer Facts and Figures 2015. Atlanta American Cancer Society, 2015. […] 5-years survival rate of 71.2% Based on2010-2012 data […] Using statistical models for analysis, rates for new vulvar cancer cases have been rising on average 0.5% each year over the last 10 years. Death rates have not changed significantly over 2002-2012. SEER 9 Incidence U.S. Mortality 1975-2012, All Races, Females. Rates are Age-Adjusted. […] Vulvar cancer is most frequently diagnosed among women aged 75-84. Median Age at Diagnosis is 68 years. SEER Stat Fact Sheets: Vulval cancer, 2014

• #13 New Insights into the Epidemiology of Vulvar Cancer: Systematic Literature Review for an Update of Incidence and Risk Factors

  https://www.mdpi.com/2072-6694/14/2/389

  The 5-year average percent incidence change was 4.6% in women of all ages, and 11.6% in those aged < 60 years. [...] The incidence increase was observed worldwide, in western countries as well as in Asia, with the exception of Colombia (Cali) and India (Chennai). [...] The number of original articles published was one in 1980–1989, 16 in 1990–1999, 19 in 2000–2009 and 33 in 2010–2020. [...] The following 19 risk factors, or risk factor categories, were investigated by two or more original studies: HPV infection; familial clustering of HPV-associated cancers; other sexually transmitted diseases; sexual behaviour; cervical intraepithelial neoplasia grade 1–3 (CIN1-3); vulvar lichen sclerosus (VLS); autoimmune diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis; menstrual and reproductive factors; oral contraceptive and menopausal hormone use; metabolic syndrome, diabetes, and body mass index (BMI); food items; alcohol consumption; smoking; human immunodeficiency virus and acquired immunodeficiency syndrome (HIV-AIDS); solid-organ transplantation; breast implants; Fanconi anaemia; previous abnormal cervical cytology; and education. [...] The epidemiologic evidence for the model centred on the role of VLS and dVIN is still inconclusive. [...] More research on the association between these two conditions and vulvar cancer is a priority.

• #14 Vulvar Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/vulva.html?statfacts_page=vulva.html&x=9&y=20

  Estimated New Cases in 2025 7,480. […] % of All New Cancer Cases 0.4%. […] Estimated Deaths in 2025 1,770. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of vulvar cancer was 2.6 per 100,000 women per year. […] Vulvar cancer represents 0.4% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 7,480 new cases of vulvar cancer and an estimated 1,770 people will die of this disease. […] Vulvar cancer is rare. It is more common among women with a medical history of vulvar intraepithelial neoplasia, human papillomavirus (HPV) infection, or genital warts. […] For vulvar cancer, death rates increase with age. The death rate was 0.6 per 100,000 women per year based on 2019-2023, age-adjusted. […] Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new vulvar cancer cases have been rising on average 0.7% each year over 2013-2022. Age-adjusted death rates have been rising on average 2.1% each year over 2014-2023.

• #15 New Insights into the Epidemiology of Vulvar Cancer: Systematic Literature Review for an Update of Incidence and Risk Factors

  https://www.mdpi.com/2072-6694/14/2/389

  The 5-year average percent incidence change was 4.6% in women of all ages, and 11.6% in those aged < 60 years. [...] The incidence increase was observed worldwide, in western countries as well as in Asia, with the exception of Colombia (Cali) and India (Chennai). [...] The number of original articles published was one in 1980–1989, 16 in 1990–1999, 19 in 2000–2009 and 33 in 2010–2020. [...] The following 19 risk factors, or risk factor categories, were investigated by two or more original studies: HPV infection; familial clustering of HPV-associated cancers; other sexually transmitted diseases; sexual behaviour; cervical intraepithelial neoplasia grade 1–3 (CIN1-3); vulvar lichen sclerosus (VLS); autoimmune diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis; menstrual and reproductive factors; oral contraceptive and menopausal hormone use; metabolic syndrome, diabetes, and body mass index (BMI); food items; alcohol consumption; smoking; human immunodeficiency virus and acquired immunodeficiency syndrome (HIV-AIDS); solid-organ transplantation; breast implants; Fanconi anaemia; previous abnormal cervical cytology; and education. [...] The epidemiologic evidence for the model centred on the role of VLS and dVIN is still inconclusive. [...] More research on the association between these two conditions and vulvar cancer is a priority.

• #16 Vulval cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/vulval-cancer/incidence

  Vulval cancer European age-standardised (AS) incidence rates for females increased by 18% in the UK between 1993-1995 and 2017-2019. […] Over the last decade in the UK (between 2007-2009 and 2017-2019), vulval cancer AS incidence rates for females remained stable. […] Vulval cancer incidence rates have varied between age groups in females in the UK since the early 1990s. […] For vulval cancer, like most cancer types, incidence trends largely reflect changing prevalence of risk factors and improvements in diagnosis and data recording. Recent incidence trends are influenced by risk factor prevalence in years past, and trends by age group reflect risk factor exposure in birth cohorts. […] The number of new vulval cancer cases in females on average each year in the UK is projected to rise from around 1,600 cases in 2023-2025 to around 2,000 cases in 2038-2040.

• #17 Vulval cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/vulval-cancer/incidence

  Vulval cancer incidence rates are projected to rise by 5% in the UK between 2023-2025 and 2038-2040, to 5 cases per 100,000 females on average each year by 2038-2040. […] Vulval cancer incidence rates (European age-standardised (AS) rates) in England in females are 74% higher in the most deprived quintile compared with the least (2013-2017). […] It is estimated that there are around 250 more cases of vulval cancer each year in England than there would be if every deprivation quintile had the same age-specific crude incidence rates as the least deprived quintile. […] An estimated 8,400 women who had been diagnosed with vulval cancer between 1991 and 2010 were alive in the UK at the end of 2010.

• #18 Vulvar Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567798/

  Vulvar cancer represents 0.3% of all new cancer cases in the United States. Squamous cell carcinoma is the most common type, usually diagnosed at ages 65 to 74. Risk factors include increasing age, HPV infection, smoking, inflammatory conditions of the vulva, prior pelvic radiation, and immunodeficiency. […] According to the Surveillance, Epidemiology, and End Results (SEER) Program, vulvar cancer represents 0.3% of all new cancer cases annually at a rate of 2.6 per 100,000 women per year in the United States. […] SEER data supports that vulvar cancer is most commonly diagnosed at ages 65 to 74, with the median age at diagnosis of 69 years. The data notes that sixty percent of diagnoses are localized and exhibit an 85% five-year survival. […] Vulvar SCC represents 90% of all vulvar cancers and typically develops by one of two pathways.

• #19 Vulvar and vaginal cancer epidemiology and molecular pathogenesis | PPT

  https://www.slideshare.net/slideshow/vulvar-and-vaginal-cancer-epidemiology-and-molecular-pathogenesis/47789486

  1. Incidence Constitutes 5% of all the malignancies of female genital tract 0.6% of female cancer Estimated new cases and deaths from vulval cancer in the United States in 2015 New cases: 5150 Deaths: 1080 Rare malignancy (28th) in the United States and accounts for 0.3% of all new cancers. Cancer Facts and Figures 2015. Atlanta American Cancer Society, 2015. […] 5-years survival rate of 71.2% Based on2010-2012 data […] Using statistical models for analysis, rates for new vulvar cancer cases have been rising on average 0.5% each year over the last 10 years. Death rates have not changed significantly over 2002-2012. SEER 9 Incidence U.S. Mortality 1975-2012, All Races, Females. Rates are Age-Adjusted. […] Vulvar cancer is most frequently diagnosed among women aged 75-84. Median Age at Diagnosis is 68 years. SEER Stat Fact Sheets: Vulval cancer, 2014

• #20 Vulval cancer incidence statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/vulval-cancer/incidence

  Vulval cancer is not among the 20 most common cancers in females in the UK, accounting for less than 1% of all new cancer cases in females (2017-2019). In females and males combined, vulval cancer is not among the 20 most common cancers in the UK, accounting for less than 1% of all new cancer cases (2017-2019). […] Vulval cancer incidence rates (European age-standardised (AS) rate) for females are similar to the UK average in all the UK constituent countries. […] In the UK in 2017-2019, on average each year more than 4 in 10 new cases (42%) were in females aged 75 and over. […] For vulval cancer, like most cancer types, incidence increases with age. This largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health.

• #21 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #22 Vulval Cancer: Symptoms, Staging, and Outcomes — DermNet

  https://dermnetnz.org/topics/vulval-cancer

  Vulval (vulvar) cancer is any malignancy arising on any part of the vulva, the external female genitalia. It is the fourth most common location for a gynaecological malignancy after the uterus, ovary, and cervix, accounting for 35% of female genital tract malignancies. […] Over 80% of vulval cancers are squamous cell carcinomas (SCC) including both precursor lesions and invasive disease. […] Vulval squamous cell carcinoma has a reported annual incidence of 27 cases per 100,000 women. […] Although it was regarded as a disease of postmenopausal women with a median age at diagnosis of 69 years in the USA, over the past forty years the incidence has increased markedly in women under 50 years of age. […] Vulval SCC risk increases with: Age, Smoking, Multiple sexual partners, Immunosuppression.

• #23 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #24 Vulvar cancer: epidemiology, clinical presentation, and management opt | IJWH

  https://www.dovepress.com/vulvar-cancer-epidemiology-clinical-presentation-and-management-option-peer-reviewed-fulltext-article-IJWH

  Epidemiology: Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #25 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #26 Vulvar cancer: epidemiology, clinical presentation, and management opt | IJWH

  https://www.dovepress.com/vulvar-cancer-epidemiology-clinical-presentation-and-management-option-peer-reviewed-fulltext-article-IJWH

  Epidemiology: Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #27 Vulvar Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/1001/p1269.html

  A retrospective review of women with vulvar cancer found a statistically significant correlation between patients younger than 45 years and HPV (relative risk [RR], 11.34), cigarette smoking (RR, 2.83), having more than two sexual partners (RR, 2.87), sexual initiation before age 19 years (RR, 2.43), and low economic status (RR, 1.77). […] Lichen sclerosus, a type of VNED, is thought to be a predisposing factor in the development of HPV-negative vulvar cancer. […] The incidence of lymph node metastasis is about 30 percent overall. The risk of nodal metastasis increases as the stage of disease, size of the lesion, and depth of invasion increase. […] The prognosis of patients with vulvar cancer is generally good when appropriate treatment is initiated in a timely fashion. The overall five-year survival is 70 percent and correlates with the stage of disease and lymph node status.

• #28 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  Vulvar cancer can be classified into two groups according to predisposing factors: the first type correlates with a HPV infection and occurs mostly in younger patients. The second group is not HPV associated and occurs often in elderly women without neoplastic epithelial disorders. […] Vulvar cancer can be distinguished into two separate diseases: the first type involves a human papillomavirus (HPV) infection that causes vulvar intraepithelial neoplasia (VIN), a predisposing factor for vulvar cancer. Early studies analyzed tissue samples from 48 patients with vulvar cancer. HPV DNA was identified by polymerase chain reaction (PCR) in 48% of explored cases, of which 96% were from subtypes 16 and 18. An estimated 80% of untreated women suffering from VIN III develop invasive vulvar cancer. This kind of vulvar cancer mentioned above often occurs in younger patients (35-65 years of age), and a recent review pointed out that approximately 15% of all vulvar cancers develop in women under age 40. Other predisposing factors, eg, condylomata or sexually transmitted diseases (STD) in the past, low economic status, or nicotine abuse, have also been found.

• #29 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  The second type of vulvar cancer includes vulvar non-neoplastic epithelial disorders (VNED) and advanced age that lead to cellular atypia and eventually to cancer. Elderly patients (55-85 years), in particular, show a low rate of HPV infections and consequently seldom any association with cervical neoplasia. Diabetes mellitus, hypertension, and obesity seem to correlate with the incidence of vulvar cancer, but do not appear to be responsible. Lichen sclerosus, a subgroup of VNED, is mooted as a predisposing risk factor in the development of HPV-negative vulvar cancer. Because of a severe pruritus caused by the lichen, the itch-scratch cycle leads to a squamous cell hyperplasia and over time a progression to atypia, followed by VIN and eventual invasive cancer. […] The prognosis of patients with vulvar cancer is quite good when convenient treatment is provided in a timely manner. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival in patients with vulvar cancer. Extracapsular growth of lymph node metastases, two or more affected lymph nodes, and more than 50% replacement of lymph nodes by tumor are predictors of poor survival. The overall 5-year survival rate ranges from 70% to 93% for patients with negative nodes and from 25% to 41% for those with positive nodes. Other prognostic factors include stage, capillary lymphatic space invasion, and older age.

• #30 Vulvar cancer: epidemiology, clinical presentation, and management opt | IJWH

  https://www.dovepress.com/vulvar-cancer-epidemiology-clinical-presentation-and-management-option-peer-reviewed-fulltext-article-IJWH

  The second type of vulvar cancer includes vulvar nonneoplastic epithelial disorders (VNED) and advanced age that lead to cellular atypia and eventually to cancer. Elderly patients (55-85 years), in particular, show a low rate of HPV infections and consequently seldom any association with cervical neoplasia. Diabetes mellitus, hypertension, and obesity seem to correlate with the incidence of vulvar cancer, but do not appear to be responsible. Lichen sclerosus, a subgroup of VNED, is mooted as a predisposing risk factor in the development of HPV-negative vulvar cancer. Because of a severe pruritus caused by the lichen, the itch-scratch cycle leads to a squamous cell hyperplasia and over time a progression to atypia, followed by VIN and eventual invasive cancer. […] The prognosis of patients with vulvar cancer is quite good when convenient treatment is provided in a timely manner. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival in patients with vulvar cancer. Extracapsular growth of lymph node metastases, two or more affected lymph nodes, and more than 50% replacement of lymph nodes by tumor are predictors of poor survival. The overall 5-year survival rate ranges from 70% to 93% for patients with negative nodes and from 25% to 41% for those with positive nodes. Other prognostic factors include stage, capillary lymphatic space invasion, and older age.

• #31 Vulvar Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/1001/p1269.html

  A retrospective review of women with vulvar cancer found a statistically significant correlation between patients younger than 45 years and HPV (relative risk [RR], 11.34), cigarette smoking (RR, 2.83), having more than two sexual partners (RR, 2.87), sexual initiation before age 19 years (RR, 2.43), and low economic status (RR, 1.77). […] Lichen sclerosus, a type of VNED, is thought to be a predisposing factor in the development of HPV-negative vulvar cancer. […] The incidence of lymph node metastasis is about 30 percent overall. The risk of nodal metastasis increases as the stage of disease, size of the lesion, and depth of invasion increase. […] The prognosis of patients with vulvar cancer is generally good when appropriate treatment is initiated in a timely fashion. The overall five-year survival is 70 percent and correlates with the stage of disease and lymph node status.

• #32 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  The second type of vulvar cancer includes vulvar non-neoplastic epithelial disorders (VNED) and advanced age that lead to cellular atypia and eventually to cancer. Elderly patients (55-85 years), in particular, show a low rate of HPV infections and consequently seldom any association with cervical neoplasia. Diabetes mellitus, hypertension, and obesity seem to correlate with the incidence of vulvar cancer, but do not appear to be responsible. Lichen sclerosus, a subgroup of VNED, is mooted as a predisposing risk factor in the development of HPV-negative vulvar cancer. Because of a severe pruritus caused by the lichen, the itch-scratch cycle leads to a squamous cell hyperplasia and over time a progression to atypia, followed by VIN and eventual invasive cancer. […] The prognosis of patients with vulvar cancer is quite good when convenient treatment is provided in a timely manner. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival in patients with vulvar cancer. Extracapsular growth of lymph node metastases, two or more affected lymph nodes, and more than 50% replacement of lymph nodes by tumor are predictors of poor survival. The overall 5-year survival rate ranges from 70% to 93% for patients with negative nodes and from 25% to 41% for those with positive nodes. Other prognostic factors include stage, capillary lymphatic space invasion, and older age.

• #33 Vulvar Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567798/

  Vulvar cancer represents 0.3% of all new cancer cases in the United States. Squamous cell carcinoma is the most common type, usually diagnosed at ages 65 to 74. Risk factors include increasing age, HPV infection, smoking, inflammatory conditions of the vulva, prior pelvic radiation, and immunodeficiency. […] According to the Surveillance, Epidemiology, and End Results (SEER) Program, vulvar cancer represents 0.3% of all new cancer cases annually at a rate of 2.6 per 100,000 women per year in the United States. […] SEER data supports that vulvar cancer is most commonly diagnosed at ages 65 to 74, with the median age at diagnosis of 69 years. The data notes that sixty percent of diagnoses are localized and exhibit an 85% five-year survival. […] Vulvar SCC represents 90% of all vulvar cancers and typically develops by one of two pathways.

• #34 Vulvar and vaginal cancer – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vulvar-and-vaginal-cancer/

  Vulvar cancer is a rare carcinoma that predominantly occurs after menopause. Major risk factors include HPV infection, smoking, vulvar intraepithelial neoplasia, and cervical intraepithelial neoplasia. […] Incidence: rare (0.7% of female cancers). […] HPV-related vulvar tumors have a higher prevalence of multifocal lesions and concurrent cervical neoplasia compared to HPV-negative tumors. […] All suspected vulvar cancer requires specialist consultation (e.g., gynecologic or surgical oncologist). […] Biopsy of all suspicious lesions with histological analysis and tumor grading is necessary for diagnostic confirmation. […] FIGO or TNM classification: helps establish prognosis and appropriate management. […] HPV vaccination reduces recurrence rates after surgical therapy. […] There are no screening tests for vulvar or vaginal cancers in asymptomatic individuals.

• #35 Vulvar Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/vulva.html

  Estimated New Cases in 2025 7,480. […] % of All New Cancer Cases 0.4%. […] Estimated Deaths in 2025 1,770. […] % of All Cancer Deaths 0.3%. […] The rate of new cases of vulvar cancer was 2.6 per 100,000 women per year. […] Vulvar cancer represents 0.4% of all new cancer cases in the U.S. […] In 2025, it is estimated that there will be 7,480 new cases of vulvar cancer and an estimated 1,770 people will die of this disease. […] Vulvar cancer is rare. It is more common among women with a medical history of vulvar intraepithelial neoplasia, human papillomavirus (HPV) infection, or genital warts. […] For vulvar cancer, death rates increase with age. The death rate was 0.6 per 100,000 women per year based on 20192023, age-adjusted. […] The percent of vulvar cancer deaths is highest among women aged 7584.

• #36 Factors associated with vulvar cancer from 2005 to 2021 in Togo, sub-Saharan Africa | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02669-6

  vulvar cancer, once predominantly diagnosed in older women, is increasingly being diagnosed in younger individuals, due to Human Papillomavirus (HPV) infection. Our study aimed to describe the epidemiological and histopathological aspects of vulvar cancer in Togo and its associated factors. […] The incidence of vulvar cancer is increasing in Togo, particularly among young, primarily due to HPV infection. […] Vulvar cancer ranks as the fourth most common gynecological cancer, following cervical, uterine, and ovarian cancers. […] In sub-Saharan Africa, vulvar cancer is often diagnosed at advanced stage. […] However, there has been a shift over time, with an increasing incidence of vulvar cancer in young women. […] Several risk factors have been implicated in this trend, including persistent HPV infection, smoking, early age at first sexual intercourse, multiple sexual partners, sexually transmitted infections such as Herpes Simplex and Papilloma Virus, immunosuppression (often associated with HIV), vulvar inflammatory diseases, family history of vulvar cancer, personal history of cervical cancer, and low socioeconomic status.

• #37 Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-cancer-epidemiology-diagnosis-histopathology-and-treatment

  Vulvar cancer is less common than other gynecologic malignancies, including uterine corpus, ovarian, and cervical cancer; in the United States, vulvar cancer is also less common than vaginal cancer. Squamous cell carcinoma is the most common histologic type of vulvar cancer, comprising at least 75 percent of cases. Other histologies include melanoma, basal cell carcinoma, Bartholin gland adenocarcinoma, sarcoma, and Paget disease. […] Human papillomavirus (HPV) infection is associated with the majority of vulvar squamous cell carcinomas. In addition, vulvar lichen sclerosus is associated with an increased risk of vulvar cancers. […] In the United States, there are approximately 7480 new cases of and 1770 deaths from vulvar cancer each year. […] Incidence rates by race or ethnicity in the United States from 2017 to 2021 were: Non-Hispanic White (3.1 per 100,000 persons), non-Hispanic Black (1.9), Asian American/Pacific Islander (1), Hispanic American (1.9), and non-Hispanic American Indian (3). In the United States, some data suggest that Black patients present with vulvar cancer at a younger age and have an increased probability of distant spread, which is a consistent finding across the different tumor models.

• #38 Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-cancer-epidemiology-diagnosis-histopathology-and-treatment/print

  Vulvar cancer is less common than other gynecologic malignancies, including uterine corpus, ovarian, and cervical cancer; in the United States, vulvar cancer is also less common than vaginal cancer. […] In the United States, there are approximately 7480 new cases of and 1770 deaths from vulvar cancer each year. […] Incidence rates by race or ethnicity in the United States from 2017 to 2021 were: Non-Hispanic White (3.1 per 100,000 persons), non-Hispanic Black (1.9), Asian American/Pacific Islander (1), Hispanic American (1.9), and non-Hispanic American Indian (3). […] In the United States, some data suggest that Black patients present with vulvar cancer at a younger age and have an increased probability of distant spread, which is a consistent finding across the different tumor models.

• #39 Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-cancer-epidemiology-diagnosis-histopathology-and-treatment/print

  Vulvar cancer is less common than other gynecologic malignancies, including uterine corpus, ovarian, and cervical cancer; in the United States, vulvar cancer is also less common than vaginal cancer. […] In the United States, there are approximately 7480 new cases of and 1770 deaths from vulvar cancer each year. […] Incidence rates by race or ethnicity in the United States from 2017 to 2021 were: Non-Hispanic White (3.1 per 100,000 persons), non-Hispanic Black (1.9), Asian American/Pacific Islander (1), Hispanic American (1.9), and non-Hispanic American Indian (3). […] In the United States, some data suggest that Black patients present with vulvar cancer at a younger age and have an increased probability of distant spread, which is a consistent finding across the different tumor models.

• #40 Vulvar Cancer — Cancer Stat Facts

  https://seer.cancer.gov/statfacts/html/vulva.html

  Keeping track of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments. […] Using statistical models for analysis, age-adjusted rates for new vulvar cancer cases have been rising on average 0.7% each year over 20132022. Age-adjusted death rates have been rising on average 2.1% each year over 20142023.

• #41 Vulvar and vaginal cancer – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vulvar-and-vaginal-cancer/

  Vulvar cancer is a rare carcinoma that predominantly occurs after menopause. Major risk factors include HPV infection, smoking, vulvar intraepithelial neoplasia, and cervical intraepithelial neoplasia. […] Incidence: rare (0.7% of female cancers). […] HPV-related vulvar tumors have a higher prevalence of multifocal lesions and concurrent cervical neoplasia compared to HPV-negative tumors. […] All suspected vulvar cancer requires specialist consultation (e.g., gynecologic or surgical oncologist). […] Biopsy of all suspicious lesions with histological analysis and tumor grading is necessary for diagnostic confirmation. […] FIGO or TNM classification: helps establish prognosis and appropriate management. […] HPV vaccination reduces recurrence rates after surgical therapy. […] There are no screening tests for vulvar or vaginal cancers in asymptomatic individuals.

• #42 Vulvar Cancer – Ovarian Cancer Research Alliance

  https://ocrahope.org/for-patients/gynecologic-cancers/vulvar-cancer/

  Vulvar cancer comprises about 6% of gynecologic cancer diagnoses. […] There is no standard screening tool for vulvar cancer. […] Close surveillance can help identify evidence of new lesions or recurrence early, which improves outcomes. […] The overall five-year relative survival rate for those diagnosed with vulvar cancer is 71%. […] The American Cancer Society estimates that in 2024 in the U.S., about 6,900 cancers of the vulva will be diagnosed, and 1,630 women will die of vulvar cancer. Vulvar cancer accounts for 1% of cancers in women, and women have about a 1 in 133 chance of developing vulvar cancer in their lifetime.

• #43 Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 22 Issue 2 (2024)

  https://jnccn.org/abstract/journals/jnccn/22/2/article-p117.xml

  However, the panel concurs with the Society of Gynecologic Oncology (SGO) recommendations for posttreatment surveillance. […] The recommended surveillance is based on the patients risk for recurrence and personal preferences. History and physical examination are recommended every 3 to 6 months for 2 years, every 6 to 12 months for another 3 to 5 years, and then annually.

• #44 Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 22 Issue 2 (2024)

  https://jnccn.org/view/journals/jnccn/22/2/article-p117.xml?print

  Vulvar cancer is annually diagnosed in an estimated 6,470 individuals and the vast majority are histologically squamous cell carcinomas. Vulvar cancer accounts for 5% to 8% of gynecologic malignancies. Known risk factors for vulvar cancer include increasing age, infection with human papillomavirus, cigarette smoking, inflammatory conditions affecting the vulva, and immunodeficiency. Most vulvar neoplasias are diagnosed at early stages. […] This manuscript discusses recommendations outlined in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for treatments, surveillance, systemic therapy options, and gynecologic survivorship. […] Most recurrences of vulvar cancer occur within the first 1 to 2 years, although recurrences beyond 5 years have been observed in a significant subset of patients. Accordingly, long-term follow-up is indicated. Definitive data on an optimal surveillance strategy are lacking. However, the panel concurs with the Society of Gynecologic Oncology (SGO) recommendations for posttreatment surveillance. […] The recommended surveillance is based on the patients risk for recurrence and personal preferences. History and physical examination are recommended every 3 to 6 months for 2 years, every 6 to 12 months for another 3 to 5 years, and then annually.

• #45 Management of Vulvar Intraepithelial Neoplasia | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/10/management-of-vulvar-intraepithelial-neoplasia

  Vulvar intraepithelial neoplasia (VIN) is an increasingly common problem, particularly among women in their 40s. […] Although spontaneous regression has been reported, VIN should be considered a premalignant condition. […] There are no screening strategies for the prevention of vulvar cancer through early detection of vulvar HSIL (VIN usual type). […] Women with vulvar HSIL (VIN usual type) are at risk of recurrent disease and vulvar cancer throughout their lifetimes. […] Given the relatively slow rate of progression, women with a complete response to therapy and no new lesions at follow-up visits scheduled 6 months and 12 months after initial treatment should be monitored by visual inspection of the vulva annually thereafter. […] Recurrence rates after treatment range from 9% to 50% with all treatment regimens and are higher with positive excision margins, and lower in surgically treated patients.

• #46 Management of Vulvar Intraepithelial Neoplasia | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/10/management-of-vulvar-intraepithelial-neoplasia

  Vulvar intraepithelial neoplasia (VIN) is an increasingly common problem, particularly among women in their 40s. […] Although spontaneous regression has been reported, VIN should be considered a premalignant condition. […] There are no screening strategies for the prevention of vulvar cancer through early detection of vulvar HSIL (VIN usual type). […] Women with vulvar HSIL (VIN usual type) are at risk of recurrent disease and vulvar cancer throughout their lifetimes. […] Given the relatively slow rate of progression, women with a complete response to therapy and no new lesions at follow-up visits scheduled 6 months and 12 months after initial treatment should be monitored by visual inspection of the vulva annually thereafter. […] Recurrence rates after treatment range from 9% to 50% with all treatment regimens and are higher with positive excision margins, and lower in surgically treated patients.

• #47 Management of Vulvar Intraepithelial Neoplasia | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/10/management-of-vulvar-intraepithelial-neoplasia

  Vulvar intraepithelial neoplasia (VIN) is an increasingly common problem, particularly among women in their 40s. […] Although spontaneous regression has been reported, VIN should be considered a premalignant condition. […] There are no screening strategies for the prevention of vulvar cancer through early detection of vulvar HSIL (VIN usual type). […] Women with vulvar HSIL (VIN usual type) are at risk of recurrent disease and vulvar cancer throughout their lifetimes. […] Given the relatively slow rate of progression, women with a complete response to therapy and no new lesions at follow-up visits scheduled 6 months and 12 months after initial treatment should be monitored by visual inspection of the vulva annually thereafter. […] Recurrence rates after treatment range from 9% to 50% with all treatment regimens and are higher with positive excision margins, and lower in surgically treated patients.

• #48 Vulvar cancer: epidemiology, clinical presentation, and management opt | IJWH

  https://www.dovepress.com/vulvar-cancer-epidemiology-clinical-presentation-and-management-option-peer-reviewed-fulltext-article-IJWH

  The second type of vulvar cancer includes vulvar nonneoplastic epithelial disorders (VNED) and advanced age that lead to cellular atypia and eventually to cancer. Elderly patients (55-85 years), in particular, show a low rate of HPV infections and consequently seldom any association with cervical neoplasia. Diabetes mellitus, hypertension, and obesity seem to correlate with the incidence of vulvar cancer, but do not appear to be responsible. Lichen sclerosus, a subgroup of VNED, is mooted as a predisposing risk factor in the development of HPV-negative vulvar cancer. Because of a severe pruritus caused by the lichen, the itch-scratch cycle leads to a squamous cell hyperplasia and over time a progression to atypia, followed by VIN and eventual invasive cancer. […] The prognosis of patients with vulvar cancer is quite good when convenient treatment is provided in a timely manner. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival in patients with vulvar cancer. Extracapsular growth of lymph node metastases, two or more affected lymph nodes, and more than 50% replacement of lymph nodes by tumor are predictors of poor survival. The overall 5-year survival rate ranges from 70% to 93% for patients with negative nodes and from 25% to 41% for those with positive nodes. Other prognostic factors include stage, capillary lymphatic space invasion, and older age.

• #49 Vulvar Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567798/

  The gold standard for diagnosing vulvar cancer remains histologic diagnosis, although clinical correlation does have significant value. […] Surgical excision is the standard therapy for vulvar cancer, but adjuvant radiation and chemotherapy may be recommended depending on the histopathology and extent of the disease. […] The decision to perform staging lymphadenectomy should be carefully considered based on the risk of occult disease and morbidity. […] The type of node assessment also impacts morbidity, with those undergoing complete lymphadenectomy at five times higher risk of lymphedema than those undergoing sentinel lymph node (SNL) biopsy. […] In vulvar cancer, the lymphatic spread is initially to homolateral superficial inguinal lymph nodes and then to deep femoroinguinal lymph nodes. Lymph node status is the most powerful prognostic factor for overall survival in patients with vulvar cancer.

• #50 Vulvar cancer: epidemiology, clinical presentation, and management options

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4374790/

  The second type of vulvar cancer includes vulvar non-neoplastic epithelial disorders (VNED) and advanced age that lead to cellular atypia and eventually to cancer. Elderly patients (55-85 years), in particular, show a low rate of HPV infections and consequently seldom any association with cervical neoplasia. Diabetes mellitus, hypertension, and obesity seem to correlate with the incidence of vulvar cancer, but do not appear to be responsible. Lichen sclerosus, a subgroup of VNED, is mooted as a predisposing risk factor in the development of HPV-negative vulvar cancer. Because of a severe pruritus caused by the lichen, the itch-scratch cycle leads to a squamous cell hyperplasia and over time a progression to atypia, followed by VIN and eventual invasive cancer. […] The prognosis of patients with vulvar cancer is quite good when convenient treatment is provided in a timely manner. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival in patients with vulvar cancer. Extracapsular growth of lymph node metastases, two or more affected lymph nodes, and more than 50% replacement of lymph nodes by tumor are predictors of poor survival. The overall 5-year survival rate ranges from 70% to 93% for patients with negative nodes and from 25% to 41% for those with positive nodes. Other prognostic factors include stage, capillary lymphatic space invasion, and older age.

• #51 Vulvar cancer: epidemiology, clinical presentation, and management opt | IJWH

  https://www.dovepress.com/vulvar-cancer-epidemiology-clinical-presentation-and-management-option-peer-reviewed-fulltext-article-IJWH

  The second type of vulvar cancer includes vulvar nonneoplastic epithelial disorders (VNED) and advanced age that lead to cellular atypia and eventually to cancer. Elderly patients (55-85 years), in particular, show a low rate of HPV infections and consequently seldom any association with cervical neoplasia. Diabetes mellitus, hypertension, and obesity seem to correlate with the incidence of vulvar cancer, but do not appear to be responsible. Lichen sclerosus, a subgroup of VNED, is mooted as a predisposing risk factor in the development of HPV-negative vulvar cancer. Because of a severe pruritus caused by the lichen, the itch-scratch cycle leads to a squamous cell hyperplasia and over time a progression to atypia, followed by VIN and eventual invasive cancer. […] The prognosis of patients with vulvar cancer is quite good when convenient treatment is provided in a timely manner. Inguinal and/or femoral node involvement is the most significant prognostic factor for survival in patients with vulvar cancer. Extracapsular growth of lymph node metastases, two or more affected lymph nodes, and more than 50% replacement of lymph nodes by tumor are predictors of poor survival. The overall 5-year survival rate ranges from 70% to 93% for patients with negative nodes and from 25% to 41% for those with positive nodes. Other prognostic factors include stage, capillary lymphatic space invasion, and older age.

• #52

  https://bpac.org.nz/2023/vulval-cancer.aspx

  Vulval cancer is a rare gynaecological cancer in New Zealand, with an average of 52 females newly diagnosed each year (from 2015 2020). […] The risk of vulval cancer increases with age and it primarily affects females who are post-menopausal with most diagnoses occurring in those aged 70 years. […] There are no screening programmes for the early detection of vulval cancer, but some people are diagnosed incidentally after an examination for other reasons, e.g. cervical screening. […] The prognosis of females with vulval cancer is usually good if diagnosed early. Overall five-year survival for people with vulval SCC is 71%; this can be above 80% in those with no lymph node involvement. […] The most significant risk factors for vulval SCC are chronic inflammatory conditions of the vulva, e.g. lichen sclerosus, erosive lichen planus, and infection with high-risk HPV, particularly type 16.

• #53 A prognostic nomogram based on lymph node ratio for postoperative vulvar squamous cell carcinoma from the Surveillance, Epidemiology, and End Results database: a retrospective cohort study

  https://atm.amegroups.org/article/view/55786/html

  Vulvar carcinoma is a rare gynecological malignancy. […] Data from 2,166 patients with pathologically confirmed diagnosis of vulvar squamous cell carcinoma from 2004 to 2015 were acquired from the Surveillance, Epidemiology, and End Results (SEER) database. […] The lymph node ratio (LNR) is defined as the ratio of the number of PLNs to the total number of RLNs, which reflects not only the burden of lymph node metastasis but also the degree of operative LN evaluation. The LNR has emerged as a vital independent prognostic factor for survival outcomes, and is superior to evaluation based on LN status in solid tumor malignancies, including cervical, endometrial, ovarian, breast, esophageal, gastric, and colorectal cancers. […] The most commonly used staging system for vulvar cancer is the FIGO score staging system. Nevertheless, studies have shown that the FIGO staging system does not incorporate many indispensable prognostic parameters, which can greatly influence vulvar squamous cell cancer patient survival, such as patient characteristics, tumor cell differentiation, LNR, HPV status, and additional factors relevant to molecular pathways of prognosis.

• #54 A prognostic nomogram based on lymph node ratio for postoperative vulvar squamous cell carcinoma from the Surveillance, Epidemiology, and End Results database: a retrospective cohort study

  https://atm.amegroups.org/article/view/55786/html

  Vulvar carcinoma is a rare gynecological malignancy. […] Data from 2,166 patients with pathologically confirmed diagnosis of vulvar squamous cell carcinoma from 2004 to 2015 were acquired from the Surveillance, Epidemiology, and End Results (SEER) database. […] The lymph node ratio (LNR) is defined as the ratio of the number of PLNs to the total number of RLNs, which reflects not only the burden of lymph node metastasis but also the degree of operative LN evaluation. The LNR has emerged as a vital independent prognostic factor for survival outcomes, and is superior to evaluation based on LN status in solid tumor malignancies, including cervical, endometrial, ovarian, breast, esophageal, gastric, and colorectal cancers. […] The most commonly used staging system for vulvar cancer is the FIGO score staging system. Nevertheless, studies have shown that the FIGO staging system does not incorporate many indispensable prognostic parameters, which can greatly influence vulvar squamous cell cancer patient survival, such as patient characteristics, tumor cell differentiation, LNR, HPV status, and additional factors relevant to molecular pathways of prognosis.

• #55 A prognostic nomogram based on lymph node ratio for postoperative vulvar squamous cell carcinoma from the Surveillance, Epidemiology, and End Results database: a retrospective cohort study

  https://atm.amegroups.org/article/view/55786/html

  In the training cohort, race, age at diagnosis, marital status, tumor grade, FIGO stage, tumor diameter, and LNR were significantly associated with OS by univariate analysis. Further multivariate analysis indicated that race, age at diagnosis, marital status, FIGO stage, tumor diameter, and LNR were independent risk factors for OS. […] Survival analysis of Kaplan-Meier curves demonstrated a significant correlation between poorer OS and the group with an LNR greater than 0.2 compared to groups with lower LNR, in both the training and validation cohorts. […] The C-index of the nomogram in the training cohort was 0.772 (95% CI: 0.7520.792), statistically superior to the C-index value of the FIGO staging system (0.676, 95% CI: 0.6540.698). […] The formulated prognostic nomogram accurately and objectively predicted OS of vulvar squamous cell carcinoma. This may have a superior prognostic capability for patients with postoperative vulvar squamous cell carcinoma compared to the currently utilized FIGO staging system.

• #56 :: JGO :: Journal of Gynecologic Oncology

  https://ejgo.org/DOIx.php?id=10.3802/jgo.2024.35.e101

  To investigate the association of primary tumor site with prognosis in vulvar cancer, stratified by vulvar squamous cell carcinoma (SCC) and non-SCC histological types. […] The primary outcome was cancer-specific survival (CSS). […] The prognostic difference between labium majus, labium minus and clitoris groups was investigated using KaplanMeier analyses and Cox proportional hazards regression analyses. […] Among vulvar non-SCC, patients with labium minus-sited disease had a significantly worse prognosis than those with labium majus-sited disease, and a significantly better prognosis than those with clitoris-sited disease. Gynecologic oncologists should consider the prognostic effect of primary tumor site in vulvar non-SCC, and make optimal, personalized treatment and surveillance strategies based on different primary tumor sites.

• #57 :: JGO :: Journal of Gynecologic Oncology

  https://ejgo.org/DOIx.php?id=10.3802/jgo.2024.35.e101

  Primary tumor site has been increasingly acknowledged as a significant prognostic factor in various malignancies, such as colon cancer, breast cancer and lung cancer. […] The primary tumor site was found to be an independent prognostic factor for patients with vulvar non-SCC. […] Vulvar non-SCC patients with clitoris-sited disease had the worst prognosis, while vulvar non-SCC patients with labium majus-sited disease had the best prognosis, with labium minus-sited vulvar non-SCC patients having a moderate prognosis.

• #58 Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-cancer-epidemiology-diagnosis-histopathology-and-treatment

  Vulvar cancer is less common than other gynecologic malignancies, including uterine corpus, ovarian, and cervical cancer; in the United States, vulvar cancer is also less common than vaginal cancer. Squamous cell carcinoma is the most common histologic type of vulvar cancer, comprising at least 75 percent of cases. Other histologies include melanoma, basal cell carcinoma, Bartholin gland adenocarcinoma, sarcoma, and Paget disease. […] Human papillomavirus (HPV) infection is associated with the majority of vulvar squamous cell carcinomas. In addition, vulvar lichen sclerosus is associated with an increased risk of vulvar cancers. […] In the United States, there are approximately 7480 new cases of and 1770 deaths from vulvar cancer each year. […] Incidence rates by race or ethnicity in the United States from 2017 to 2021 were: Non-Hispanic White (3.1 per 100,000 persons), non-Hispanic Black (1.9), Asian American/Pacific Islander (1), Hispanic American (1.9), and non-Hispanic American Indian (3). In the United States, some data suggest that Black patients present with vulvar cancer at a younger age and have an increased probability of distant spread, which is a consistent finding across the different tumor models.

• #59 Vulvar Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567798/

  Vulvar cancer represents 0.3% of all new cancer cases in the United States. Squamous cell carcinoma is the most common type, usually diagnosed at ages 65 to 74. Risk factors include increasing age, HPV infection, smoking, inflammatory conditions of the vulva, prior pelvic radiation, and immunodeficiency. […] According to the Surveillance, Epidemiology, and End Results (SEER) Program, vulvar cancer represents 0.3% of all new cancer cases annually at a rate of 2.6 per 100,000 women per year in the United States. […] SEER data supports that vulvar cancer is most commonly diagnosed at ages 65 to 74, with the median age at diagnosis of 69 years. The data notes that sixty percent of diagnoses are localized and exhibit an 85% five-year survival. […] Vulvar SCC represents 90% of all vulvar cancers and typically develops by one of two pathways.

• #60 Vulvar cancer: Epidemiology, diagnosis, histopathology, and treatment – UpToDate

  https://www.uptodate.com/contents/vulvar-cancer-epidemiology-diagnosis-histopathology-and-treatment

  Vulvar cancer is less common than other gynecologic malignancies, including uterine corpus, ovarian, and cervical cancer; in the United States, vulvar cancer is also less common than vaginal cancer. Squamous cell carcinoma is the most common histologic type of vulvar cancer, comprising at least 75 percent of cases. Other histologies include melanoma, basal cell carcinoma, Bartholin gland adenocarcinoma, sarcoma, and Paget disease. […] Human papillomavirus (HPV) infection is associated with the majority of vulvar squamous cell carcinomas. In addition, vulvar lichen sclerosus is associated with an increased risk of vulvar cancers. […] In the United States, there are approximately 7480 new cases of and 1770 deaths from vulvar cancer each year. […] Incidence rates by race or ethnicity in the United States from 2017 to 2021 were: Non-Hispanic White (3.1 per 100,000 persons), non-Hispanic Black (1.9), Asian American/Pacific Islander (1), Hispanic American (1.9), and non-Hispanic American Indian (3). In the United States, some data suggest that Black patients present with vulvar cancer at a younger age and have an increased probability of distant spread, which is a consistent finding across the different tumor models.

• #61 Vulvar Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK567798/

  Vulvar cancer represents 0.3% of all new cancer cases in the United States. Squamous cell carcinoma is the most common type, usually diagnosed at ages 65 to 74. Risk factors include increasing age, HPV infection, smoking, inflammatory conditions of the vulva, prior pelvic radiation, and immunodeficiency. […] According to the Surveillance, Epidemiology, and End Results (SEER) Program, vulvar cancer represents 0.3% of all new cancer cases annually at a rate of 2.6 per 100,000 women per year in the United States. […] SEER data supports that vulvar cancer is most commonly diagnosed at ages 65 to 74, with the median age at diagnosis of 69 years. The data notes that sixty percent of diagnoses are localized and exhibit an 85% five-year survival. […] Vulvar SCC represents 90% of all vulvar cancers and typically develops by one of two pathways.

• #62 A prognostic nomogram based on lymph node ratio for postoperative vulvar squamous cell carcinoma from the Surveillance, Epidemiology, and End Results database: a retrospective cohort study

  https://atm.amegroups.org/article/view/55786/html

  Vulvar carcinoma is a rare gynecological malignancy. […] Data from 2,166 patients with pathologically confirmed diagnosis of vulvar squamous cell carcinoma from 2004 to 2015 were acquired from the Surveillance, Epidemiology, and End Results (SEER) database. […] The lymph node ratio (LNR) is defined as the ratio of the number of PLNs to the total number of RLNs, which reflects not only the burden of lymph node metastasis but also the degree of operative LN evaluation. The LNR has emerged as a vital independent prognostic factor for survival outcomes, and is superior to evaluation based on LN status in solid tumor malignancies, including cervical, endometrial, ovarian, breast, esophageal, gastric, and colorectal cancers. […] The most commonly used staging system for vulvar cancer is the FIGO score staging system. Nevertheless, studies have shown that the FIGO staging system does not incorporate many indispensable prognostic parameters, which can greatly influence vulvar squamous cell cancer patient survival, such as patient characteristics, tumor cell differentiation, LNR, HPV status, and additional factors relevant to molecular pathways of prognosis.

• #63 Vulvar Cancer | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/1001/p1269.html

  A retrospective review of women with vulvar cancer found a statistically significant correlation between patients younger than 45 years and HPV (relative risk [RR], 11.34), cigarette smoking (RR, 2.83), having more than two sexual partners (RR, 2.87), sexual initiation before age 19 years (RR, 2.43), and low economic status (RR, 1.77). […] Lichen sclerosus, a type of VNED, is thought to be a predisposing factor in the development of HPV-negative vulvar cancer. […] The incidence of lymph node metastasis is about 30 percent overall. The risk of nodal metastasis increases as the stage of disease, size of the lesion, and depth of invasion increase. […] The prognosis of patients with vulvar cancer is generally good when appropriate treatment is initiated in a timely fashion. The overall five-year survival is 70 percent and correlates with the stage of disease and lymph node status.

• #64

  https://link.springer.com/article/10.1007/s00404-011-1850-9

  Due to a change in sexual behavior and an increased rate of HPV infection among younger women, increased incidence of both diseases has to be expected. The age-standardized mortality rate of vulvar carcinoma in Europe is stated at 0.7/100,000 women, and that of vaginal carcinoma at 0.4/100,000 women. To what extent the HPV-vaccination affects incidence and mortality rates is continually being observed.

• #65 Krebs – Cancer of the vulva

  https://www.krebsdaten.de/Krebs/EN/Content/Cancer_sites/Vulva_cancer/vulva_cancer_node.html

  Through the first decade of this millennium, a substantial increase in incidence rates and a slight increase in mortality rates from vulvar cancer were observed in Germany. Since then, the rates have remained largely stable. In 2020, about 3,090 women were diagnosed with a malignant neoplasm of the vulva; 973 women died of this disease in the same year. […] The greatest burden of disease is found among women over 70 years of age: the mean age at diagnosis of vulvar cancer is 73 years. The relative 5-year survival rate after diagnosis is 70 percent. Among cases with valid stage information, local tumours (stage I, limited to vulva/perineum) are the most common (approximately 70 percent). […] Over the past several years, the highest rates of vulvar and cervical cancer have been found in the Federal State of Saarland. While mortality rates are largely comparable, incidence rates in Germany are higher than in neighbouring countries (figures not available from all neighbouring countries).

• #66 Vulval cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/vulval-cancer

  There are around 1,400 new vulval cancer cases in the UK every year, that’s around 4 every day (2017-2019). […] Vulval cancer accounts for less than 1% of all new cancer cases in females in the UK (2017-2019). […] Vulval cancer incidence rates are projected to rise by 5% in the UK between 2023-2025 and 2038-2040. […] Vulval cancer is the 20th most common cause of cancer death in females in the UK, accounting for less than 1% of all cancer deaths in females in the UK (2017-2019). […] Mortality rates for vulval cancer in the UK are highest in females aged 90+ (2017-2019). […] Vulval cancer mortality rates are projected to rise by 20% in the UK between 2023-2025 and 2038-2040. […] 69% of vulval cancer cases in the UK are preventable.

• #67 Vulvar cancer statistics | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/vulvar/statistics

  Statistics for vulvar cancer are not reported separately but are included in the general category other female genital system cancers. This broad category includes vulvar and similar cancers together. So the numbers do not necessarily show the new cases (incidence) and deaths (mortality) specifically for vulvar cancer. […] In 2019, there were 1,070 Canadian women diagnosed with other female genital system cancers. […] In 2022, 488 Canadian women died from other female genital system cancers.

• #68 Factors associated with vulvar cancer from 2005 to 2021 in Togo, sub-Saharan Africa | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02669-6

  vulvar cancer, once predominantly diagnosed in older women, is increasingly being diagnosed in younger individuals, due to Human Papillomavirus (HPV) infection. Our study aimed to describe the epidemiological and histopathological aspects of vulvar cancer in Togo and its associated factors. […] The incidence of vulvar cancer is increasing in Togo, particularly among young, primarily due to HPV infection. […] Vulvar cancer ranks as the fourth most common gynecological cancer, following cervical, uterine, and ovarian cancers. […] In sub-Saharan Africa, vulvar cancer is often diagnosed at advanced stage. […] However, there has been a shift over time, with an increasing incidence of vulvar cancer in young women. […] Several risk factors have been implicated in this trend, including persistent HPV infection, smoking, early age at first sexual intercourse, multiple sexual partners, sexually transmitted infections such as Herpes Simplex and Papilloma Virus, immunosuppression (often associated with HIV), vulvar inflammatory diseases, family history of vulvar cancer, personal history of cervical cancer, and low socioeconomic status.

• #69 Factors associated with vulvar cancer from 2005 to 2021 in Togo, sub-Saharan Africa | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02669-6

  Among the 32 cases, 27 had identifiable risk factors, with HPV infection being the most prevalent (33.3%). […] Statistically significant associations were found between risk factors and histological types, risk factors and degrees of differentiation, as well as between histological types and good differentiation of vulvar cancers. […] The ulcero-budding aspect was most frequently observed, and squamous cell carcinoma was the most common histological type, with the majority being well differentiated (89.3%). […] In a 2017 study on cancer epidemiology in Togo, Darr et al. reported a 0.6% frequency of vulvar cancers. […] HPV infection demonstrated a statistically significant association with the histological type of vulvar cancers (p-value=0.0041). […] The prognosis for patients with vulvar cancer is quite good when the treatment is given in time.

• #70 Cervical, vaginal and vulvar cancer incidence and survival trends in Denmark, Finland, Norway and Sweden with implications to treatment | BMC Cancer | Full Text

  https://bmccancer.biomedcentral.com/articles/10.1186/s12885-022-09582-5

  Incidence of cervical cancer has been reduced by organized screening while for vaginal and vulvar cancers no systematic screening has been implemented. […] The incidence of vaginal and vulvar cancer remained relatively constant at about 2/100,000. […] Survival in vaginal and vulvar cancer followed the same patterns but at a few % units lower level. […] The incidence of vaginal and vulvar cancer remained relatively constant at about 2/100,000. […] Considering that limited improvement in survival was observed between years 1 and 5 and that no improvement in survival was evident among patients diagnosed past the screening age, the study fails to find evidence that treatment, other than local excision triggered by screening, would have contributed to the survival improvements over the 50-year period.

• #71 Follow-up after treatment for vulvar cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/vulvar/treatment/follow-up

  Follow-up after treatment is an important part of cancer care. Follow-up for vulvar cancer is often shared among different cancer specialists (oncologists), the surgeon and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs. […] The chance that vulvar cancer will come back (recur) is greatest within 5 years, so you will need close follow-up during this time. […] Follow-up visits for vulvar cancer are usually scheduled: […] Tests can be done as part of follow-up care. You may have: […] If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.

• #72 Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 22 Issue 2 (2024)

  https://jnccn.org/abstract/journals/jnccn/22/2/article-p117.xml

  Vulvar cancer is annually diagnosed in an estimated 6,470 individuals and the vast majority are histologically squamous cell carcinomas. Vulvar cancer accounts for 5% to 8% of gynecologic malignancies. Known risk factors for vulvar cancer include increasing age, infection with human papillomavirus, cigarette smoking, inflammatory conditions affecting the vulva, and immunodeficiency. Most vulvar neoplasias are diagnosed at early stages. […] This manuscript discusses recommendations outlined in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for treatments, surveillance, systemic therapy options, and gynecologic survivorship. […] Most recurrences of vulvar cancer occur within the first 1 to 2 years, although recurrences beyond 5 years have been observed in a significant subset of patients. Accordingly, long-term follow-up is indicated.

• #73 Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 22 Issue 2 (2024)

  https://jnccn.org/abstract/journals/jnccn/22/2/article-p117.xml

  However, the panel concurs with the Society of Gynecologic Oncology (SGO) recommendations for posttreatment surveillance. […] The recommended surveillance is based on the patients risk for recurrence and personal preferences. History and physical examination are recommended every 3 to 6 months for 2 years, every 6 to 12 months for another 3 to 5 years, and then annually.

• #74 Vulvar Cancer, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology in: Journal of the National Comprehensive Cancer Network Volume 22 Issue 2 (2024)

  https://jnccn.org/view/journals/jnccn/22/2/article-p117.xml?print

  Vulvar cancer is annually diagnosed in an estimated 6,470 individuals and the vast majority are histologically squamous cell carcinomas. Vulvar cancer accounts for 5% to 8% of gynecologic malignancies. Known risk factors for vulvar cancer include increasing age, infection with human papillomavirus, cigarette smoking, inflammatory conditions affecting the vulva, and immunodeficiency. Most vulvar neoplasias are diagnosed at early stages. […] This manuscript discusses recommendations outlined in the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for treatments, surveillance, systemic therapy options, and gynecologic survivorship. […] Most recurrences of vulvar cancer occur within the first 1 to 2 years, although recurrences beyond 5 years have been observed in a significant subset of patients. Accordingly, long-term follow-up is indicated. Definitive data on an optimal surveillance strategy are lacking. However, the panel concurs with the Society of Gynecologic Oncology (SGO) recommendations for posttreatment surveillance. […] The recommended surveillance is based on the patients risk for recurrence and personal preferences. History and physical examination are recommended every 3 to 6 months for 2 years, every 6 to 12 months for another 3 to 5 years, and then annually.

• #75 Vulvar and vaginal cancer epidemiology and molecular pathogenesis | PPT

  https://www.slideshare.net/slideshow/vulvar-and-vaginal-cancer-epidemiology-and-molecular-pathogenesis/47789486

  Approximately, 40% vulvar cancers are HPV (Human Papilloma Virus) Positive. Of these HPV positive invasive vulvar cancers 85% are attributed to HPV 16. Prophylactic HPV vaccines have the potential to decrease the incidence of invasive vulvar cancer by about one-third overall, and to be even more effective in younger women. […] There has been a significant increase in the incidence of vulvar intraepithelial Neoplasia (VIN) in recent decades, and this has been attributed to changing sexual behavior, human papillomavirus (HPV) infection, and cigarette smoking. […] differentiated VIN had a higher risk of malignancy (85.7%) than usual VIN (25.8%), lichen sclerosus (27.7%) or Squamous hyperplasia (31.7%). […] The increased risk of a subsequent cancer to be 1.3-fold. Most of the second cancers were related to smoking (i.e., cancers of the lung, buccal cavity, pharynx, nasal cavity, or larynx) or human papillomavirus infections (e.g., cervix, vagina, or anus).

• #76 Vulvar Cancer | Foundation For Women’s Cancer

  https://foundationforwomenscancer.org/gynecologic-cancers/gynecologic-cancer-types/vulvar-cancer/

  Vulvar cancer begins in the vulva, which is the external genitalia that comprises of the inner and outer labia (lips), clitoris, urethra where urine exits, opening of the vagina and its glands, as well as the area of skin between the vagina and anus. It is a rare cancer that can be associated with smoking, human papillomavirus (HPV) infections, as well as conditions of the vulva associated with chronic irritation and inflammation. Cancer of the vulva is a rare tumor with the most recent cancer statistics reporting that approximately 5,000 people with gynecologic systems in the U.S. are afflicted annually. […] Protection from infection with the Human Papillomavirus (HPV), including HPV vaccination, reduces the risk of vulvar cancer. Examination of the vulva for changes by a person at home or by their gynecologist during their annual pelvic examination can lead to the detection of preinvasive disease or early vulvar cancer. Suspicious or unexplained changes on the vulva should be biopsied.

• #77 Vulval cancer statistics | Cancer Research UK

  https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/vulval-cancer

  There are around 1,400 new vulval cancer cases in the UK every year, that’s around 4 every day (2017-2019). […] Vulval cancer accounts for less than 1% of all new cancer cases in females in the UK (2017-2019). […] Vulval cancer incidence rates are projected to rise by 5% in the UK between 2023-2025 and 2038-2040. […] Vulval cancer is the 20th most common cause of cancer death in females in the UK, accounting for less than 1% of all cancer deaths in females in the UK (2017-2019). […] Mortality rates for vulval cancer in the UK are highest in females aged 90+ (2017-2019). […] Vulval cancer mortality rates are projected to rise by 20% in the UK between 2023-2025 and 2038-2040. […] 69% of vulval cancer cases in the UK are preventable.

• #78

  https://bpac.org.nz/2023/vulval-cancer.aspx

  HPV vaccination is recommended for all females (and males) ideally before the onset of sexual activity, and is funded for eligible people aged 9 26 years inclusive. […] The majority of vulval cancer precursor lesions (approximately 95%) are HSIL (previously referred to as usual-type VIN, VIN 2/3 or Bowen disease of the vulva), but these are associated with a low risk and rate of progression to invasive vulval cancer. […] In comparison, differentiated VIN, although less common than HSIL has a high risk and rapid rate of progression to invasive vulval cancer. […] The diagnosis of vulval cancer involves the recognition of suspicious vulvovaginal symptoms from a focused patient history, followed by investigation with a pelvic examination to detect any abnormal changes to vulval appearance. […] The biopsy results may indicate the presence of a vulval condition such as lichen sclerosus or Paget disease of the vulva, or it may show a precursor or malignant lesion.

• #79 Vulvar and vaginal cancer epidemiology and molecular pathogenesis | PPT

  https://www.slideshare.net/slideshow/vulvar-and-vaginal-cancer-epidemiology-and-molecular-pathogenesis/47789486

  Approximately, 40% vulvar cancers are HPV (Human Papilloma Virus) Positive. Of these HPV positive invasive vulvar cancers 85% are attributed to HPV 16. Prophylactic HPV vaccines have the potential to decrease the incidence of invasive vulvar cancer by about one-third overall, and to be even more effective in younger women. […] There has been a significant increase in the incidence of vulvar intraepithelial Neoplasia (VIN) in recent decades, and this has been attributed to changing sexual behavior, human papillomavirus (HPV) infection, and cigarette smoking. […] differentiated VIN had a higher risk of malignancy (85.7%) than usual VIN (25.8%), lichen sclerosus (27.7%) or Squamous hyperplasia (31.7%). […] The increased risk of a subsequent cancer to be 1.3-fold. Most of the second cancers were related to smoking (i.e., cancers of the lung, buccal cavity, pharynx, nasal cavity, or larynx) or human papillomavirus infections (e.g., cervix, vagina, or anus).

• #80 Vulvar Cancer | Foundation For Women’s Cancer

  https://foundationforwomenscancer.org/gynecologic-cancers/gynecologic-cancer-types/vulvar-cancer/

  Vulvar cancer begins in the vulva, which is the external genitalia that comprises of the inner and outer labia (lips), clitoris, urethra where urine exits, opening of the vagina and its glands, as well as the area of skin between the vagina and anus. It is a rare cancer that can be associated with smoking, human papillomavirus (HPV) infections, as well as conditions of the vulva associated with chronic irritation and inflammation. Cancer of the vulva is a rare tumor with the most recent cancer statistics reporting that approximately 5,000 people with gynecologic systems in the U.S. are afflicted annually. […] Protection from infection with the Human Papillomavirus (HPV), including HPV vaccination, reduces the risk of vulvar cancer. Examination of the vulva for changes by a person at home or by their gynecologist during their annual pelvic examination can lead to the detection of preinvasive disease or early vulvar cancer. Suspicious or unexplained changes on the vulva should be biopsied.

• #81 Vulvar and vaginal cancer – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vulvar-and-vaginal-cancer/

  Vulvar cancer is a rare carcinoma that predominantly occurs after menopause. Major risk factors include HPV infection, smoking, vulvar intraepithelial neoplasia, and cervical intraepithelial neoplasia. […] Incidence: rare (0.7% of female cancers). […] HPV-related vulvar tumors have a higher prevalence of multifocal lesions and concurrent cervical neoplasia compared to HPV-negative tumors. […] All suspected vulvar cancer requires specialist consultation (e.g., gynecologic or surgical oncologist). […] Biopsy of all suspicious lesions with histological analysis and tumor grading is necessary for diagnostic confirmation. […] FIGO or TNM classification: helps establish prognosis and appropriate management. […] HPV vaccination reduces recurrence rates after surgical therapy. […] There are no screening tests for vulvar or vaginal cancers in asymptomatic individuals.

• #82 Vulvar and vaginal cancer – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vulvar-and-vaginal-cancer/

  Vulvar cancer is a rare carcinoma that predominantly occurs after menopause. Major risk factors include HPV infection, smoking, vulvar intraepithelial neoplasia, and cervical intraepithelial neoplasia. […] Incidence: rare (0.7% of female cancers). […] HPV-related vulvar tumors have a higher prevalence of multifocal lesions and concurrent cervical neoplasia compared to HPV-negative tumors. […] All suspected vulvar cancer requires specialist consultation (e.g., gynecologic or surgical oncologist). […] Biopsy of all suspicious lesions with histological analysis and tumor grading is necessary for diagnostic confirmation. […] FIGO or TNM classification: helps establish prognosis and appropriate management. […] HPV vaccination reduces recurrence rates after surgical therapy. […] There are no screening tests for vulvar or vaginal cancers in asymptomatic individuals.

• #83 Vulvar and vaginal cancer – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vulvar-and-vaginal-cancer/

  Vulvar cancer is a rare carcinoma that predominantly occurs after menopause. Major risk factors include HPV infection, smoking, vulvar intraepithelial neoplasia, and cervical intraepithelial neoplasia. […] Incidence: rare (0.7% of female cancers). […] HPV-related vulvar tumors have a higher prevalence of multifocal lesions and concurrent cervical neoplasia compared to HPV-negative tumors. […] All suspected vulvar cancer requires specialist consultation (e.g., gynecologic or surgical oncologist). […] Biopsy of all suspicious lesions with histological analysis and tumor grading is necessary for diagnostic confirmation. […] FIGO or TNM classification: helps establish prognosis and appropriate management. […] HPV vaccination reduces recurrence rates after surgical therapy. […] There are no screening tests for vulvar or vaginal cancers in asymptomatic individuals.

• #84 Vulvar Cancer – Ovarian Cancer Research Alliance

  https://ocrahope.org/for-patients/gynecologic-cancers/vulvar-cancer/

  Vulvar cancer comprises about 6% of gynecologic cancer diagnoses. […] There is no standard screening tool for vulvar cancer. […] Close surveillance can help identify evidence of new lesions or recurrence early, which improves outcomes. […] The overall five-year relative survival rate for those diagnosed with vulvar cancer is 71%. […] The American Cancer Society estimates that in 2024 in the U.S., about 6,900 cancers of the vulva will be diagnosed, and 1,630 women will die of vulvar cancer. Vulvar cancer accounts for 1% of cancers in women, and women have about a 1 in 133 chance of developing vulvar cancer in their lifetime.

• #85 Management of Vulvar Intraepithelial Neoplasia | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2016/10/management-of-vulvar-intraepithelial-neoplasia

  Vulvar intraepithelial neoplasia (VIN) is an increasingly common problem, particularly among women in their 40s. […] Although spontaneous regression has been reported, VIN should be considered a premalignant condition. […] There are no screening strategies for the prevention of vulvar cancer through early detection of vulvar HSIL (VIN usual type). […] Women with vulvar HSIL (VIN usual type) are at risk of recurrent disease and vulvar cancer throughout their lifetimes. […] Given the relatively slow rate of progression, women with a complete response to therapy and no new lesions at follow-up visits scheduled 6 months and 12 months after initial treatment should be monitored by visual inspection of the vulva annually thereafter. […] Recurrence rates after treatment range from 9% to 50% with all treatment regimens and are higher with positive excision margins, and lower in surgically treated patients.

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