Background: Vulvar cancer is one of the rare malignancies of the female genital tract. Vulvar cancer is predominantly a disease of post-menopausal multiparous women. Objective: The aim of this study was to analyse and report the clinico-pathological features and treatment modalities of patients with vulvar cancer treated at National Institute of Cancer Research and Hospital (NICR&H), Dhaka, Bangladesh. Methods: This was a cross- sectional observational study conducted among 96 vulvar cancer cases treated at National Institute of Cancer Research and Hospital (NICR&H), Dhaka, Bangladesh from 2015 to 2020. The medical records of patients with vulvar cancer were retrospectively reviewed after obtaining approval from the Institutional Review Board (IRB). Clinical details of all vulvar cancer patients and treatment given were collected from the hospital records and were reviewed retrospectively. Results: A total of 96 patients with vulvar cancer were included for this retrospective analysis. The median age was 50 years (range, 12- 85 years) with a mean (±SD) of 50.50±15.12 years. Stages of the disease were: stage I: 27.1% patients; stage II: 22.9% patients; stage III: 30.3% patients; stage IV: 16.7% patients; and unknown stage: 3.1% patient as per International Federation of Gynecology and Obstetrics (FIGO) staging system. Histopathologically, squamous cell carcinoma (SCC) was the most common histologic type (84.4%) followed by adenocarcinoma (5.2%), melanoma (4.2%), basal cell carcinoma (3.1%), and others (3.1%). Most of the patients (45.8%) were treated by surgery with or without adjuvant radiotherapy. About 24.0% of patients were treated primarily by radiotherapy and/or chemo-radiotherapy. Conclusion: Management of vulvar cancer requires multidisciplinary team approach, which is available only in tertiary care centres. The treatment of vulvar cancer is surgery, radiotherapy, chemo- radiotherapy or a combination therapy. Treatment should be individualised based on lesions location and histological type. Bangladesh Med Res Counc Bull 2022; 48(1): 64-70

Background: Cervical cancer-a preventable disease, is the second most commonly diagnosed cancer among women of developing countries. Paps smear is the gold standard screening method worldwide. But a low-cost test, visual inspection of cervix with acetic acid (VIA) has been emerged as an alternative for use in lowresource settings. VIA is simple and easy to perform by auxiliary health professionals. Colposcopy is an essential procedure in the evaluation of screen positive cervix though it requires considerable training and experience. Objective: The objective of this study was to evaluate the VIA positive cases by colposcopy, colposcopy guided biopsy and histopathological examination. Methods: This was a cross sectional observational study conducted among 100 VIA positive cases attended at GOPD of Dhaka Medical College Hospital from July 2014 to December 2014. Colposcopy was performed in all VIA positive cases. Subsequent biopsy and histopathological examinations were done for those with colposcopic abnormal findings. Results: The mean age of the study population was 37.9±9.3 years. Among VIA positive cases 66.0% had complaints of whitish vaginal discharge. Among the study population, colposcopically 46.0% had healthy cervix (normal) and 54.0% had abnormal findings. Colposcopy guided biopsy was taken from those with abnormal findings. Histopathological findings were normal in 38.9% cases, chronic cervicitis in 20.37% cases, squamous cell metaplasia in 3.7% cases, CIN I in 16.7%, CIN II in11.11%, CIN III in 5.6% and 3.7% cases were carcinoma cervix. True positive value was 20, false positive value 34 and positive predictive value of colposcopy was 37.03%. Conclusion: This study concluded that VIA is effective in detection of CIN and invasive carcinoma of cervix. It also suggests the role of colposcopy in the evaluation of CIN and other cervical diseases in screen positive cases. VIA can be used as a screening tool in low and middle income countries like Bangladesh, not only in rural areas and small health centres, but also in hospitals, cancer institutes, and other health facilities with better resources. Bangladesh Med Res Counc Bull 2022; 48(1): 27-32