Rising and Falling Trends in Incidence Rates of Vulvar and Vaginal Cancers in the United States, 2000-2016

Abstract

Background: Few studies focus on incidence trends in vulvar and vaginal by histological type, race, age, and region. We aimed to evaluate the temporal incidence trends and survival for the two cancers.Methods: Cases with primary vulvar or vaginal carcinoma from 2000-2016 were identified from the Surveillance, Epidemiology, and End Results 18 registries. Annual percent change (APC) and average APC (AAPC) were calculated to evaluated trends. Relative survival was estimated to compare survival outcomes.Results: Vulvar cancer incidence rates were highest among non-Hispanic whites (20.9 per 1,000,000 person-years) and in the Midwest (27.7), while vaginal cancer rates were highest among non-Hispanic blacks (8.2) and in the South (6.7). Overall, vulvar cancer rate increased 0.4% annually (AAPC, 0.4%; 95% CI, 0.1% to 0.6%), but vaginal cancer rate decreased 1.4% annually (AAPC, -1.4%; 95% CI, -2.0% to -0.5%). The increased vulvar cancer rate was only observed for squamous cell carcinoma (APC, 1.0%), while the decreased vaginal cancer rate was only observed for other malignancies (APC, -1.7%). Vulvar cancer rates increased only among whites (APC, 1.2%), but vaginal cancer rates decreased only among whites (AAPC, -1.3%) and Asians (APC, -2.7%). Vulvar cancer rates increased among patients aged 50-59 (APC, 1.1%), 60-69 (APC, 1.3%), and 70-79 (APC, 1.2%) years, while vaginal cancer rates decreased among patients aged 50-59 (APC, -1.4%) and 80 (APC, -1.4%) years or older. Overall, whites had the highest five-year relative survival for both vulvar (72.22%) and vaginal (49.03%) cancers. Conclusion: There were profound disparities in vulvar and vaginal cancer incidence rates attributable to histological type, race, age, and region. The increased vulvar cancer rates and the declined vaginal cancer rate highlights the importance of further studies to investigate the reason for the disparities.

Global incidence, risk factors and trends of vulvar cancer: A country‐based analysis of cancer registries

“…We have found an increasing trend of vulvar cancer incidence, which is in line with previous findings from national studies 43‐46 . There are some common explanations to increasing incidence rate in cancer, including improved diagnostic procedures, increasing awareness of the disease and increasing prevalence of risk factors 44 .…”

“…We have found an increasing trend of vulvar cancer incidence, which is in line with previous findings from national studies. [43][44][45][46] There are some common explanations to increasing incidence rate in cancer, including improved diagnostic procedures, increasing awareness of the disease and increasing prevalence of risk factors. 44 For instance, a highly significant increasing trend is found in Germany, possibly led by a higher HPV prevalence owing to more permissive sexual behaviors in German female birth cohorts from 1940 onwards, 47 and the increase in smoking prevalence and the decline in the age of smoking initiation.…”

Trends in the Incidence of Vulvar and Vaginal Cancers With Different Histology by Race, Age, and Region in the United States (2001–2018)

“…A similar preprinted study we previously carried out on the trends in the incidence of the United States between 2000-2016 based on the SEER database could be found on the Research Square [30].…”