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

Abstract

Objectives: The race, age, and region-stratified incidence of vulvar (VUC) and vaginal (VAC) cancers with different histology were unclear.Methods: Data was retrieved from the United States Cancer Statistics database. Average annual percent change (AAPC) and incidence rate ratio (IRR) were calculated.Results: Overall, VUC incidence increased from 18.3 (per 1,000,000 woman-years) to 19.6, but VAC incidence decreased from 5.6 to 4.4. VUC squamous cell carcinoma (SCC) incidence increased (AAPC, 0.96; 95% CI, 0.66–1.25), VUC adenocarcinoma (ADE) incidence stabilized (AAPC, −0.24; 95% CI, −1.44 to 0.98), and VUC other malignancies (OM) incidence decreased (AAPC, −1.31; 95% CI, −2.58 to −0.02). While VAC incidence decreased for any histology (AAPC, -0.63; 95% CI, −1.03 to −0.22; AAPC, −1.60; 95% CI, −2.80 to −0.39; and AAPC, −1.57; 95% CI, −2.24 to −0.89 for SCC, ADE, and OM). Similar trends were observed in most of the stratifications.Conclusion: VUC and VAC incidences varied by histology overall and within stratifications by race, age, and region. The incidence decreased for VUC and VAC with all histologies, except for the increasing VUC SCC incidence.

Vulvar cancer incidence and net survival in Sweden 1960 to 2019: A population‐based national study

“…In the study from Japan between 2001 and 2010, the number of vulvar cancer cases increased in women ≥80 years of age from 18.0% to 30.6% ( P < 0.05) in Japanese women during the study period; this change was not seen in the US validation cohort (25.2% to 27.8%; P = 0.160) 30 . Another study from USA in 2001–2018 observed an increase in vulvar SCC in women aged 70–79 years of age at diagnosis, but no change for women ≥80 years of age 4 . The SQRGC study on vulvar SCC observed that fewer women ≥80 years of age did not receive any cancer treatment due, for example, to comorbidity, poor performance status or patients’ wish 28 .…”

“…29 This dis- ogies. 4 In a study from Japan between 2001 and 2010, SCC constituted 72.4% of cases, followed by Paget's disease (14.3%) and AC (5.6%). 30 During the study period a decrease in age-standardized incidence of MM of the vulva was found, whereas an increase in the age-standardized incidence of AC was observed.…”

“…Zhou et al. investigated age‐adjusted incidence rates of vulvar cancer in the USA between 2001 and 2018 and observed that 78.3% were SCC, 1.6% were AC and the remaining 20.0% consisted of other morphologies 4 . In a study from Japan between 2001 and 2010, SCC constituted 72.4% of cases, followed by Paget's disease (14.3%) and AC (5.6%) 30 …”

“…The remaining few cases consist of even rarer tumors, eg sarcoma and basal cell carcinoma 2 . Adenocarcinomas of the vulva are rare and an American study observed an age‐adjusted incidence rate of vulvar adenocarcinoma of 0.3 per 1 000 000 women between 2001 and 2018 4 . Approximately 40% of vulvar cases are human papilloma virus (HPV)‐related, 5,6 mostly affecting younger women 7 .…”

The modified 5-item frailty index is a predictor of post-operative complications in vulvar cancer: a National Surgical Quality Improvement Program (NSQIP) analysis

“…While women with vulvar cancer are on average older at diagnosis, compared with other gynecologic cancers, we understand that other variables exist that may impact post-operative and oncologic outcomes and that many women are diagnosed at a younger age. For example, Black women may be diagnosed with vulvar cancer at an earlier age, with more advanced disease, and have significantly worse outcomes 32–34. Due to the relative rarity of vulvar cancer, there is limited research to support how specific medical comorbidities influence oncologic and surgical outcomes.…”