Vulvar cancer is a relatively uncommon malignancy, occurring at a rate of 2.2 per 100,000 women per year, Dr. Patricia L. Judson, of the University of Minnesota, Minneapolis, and colleagues note. However, a recent Surveillance, Epidemiology, and End Result Program-derived data review demonstrated that over the past 28 years, the prevalence of in situ and invasive vulvar carcinoma has increased, they add.

The researchers examined demographic, surgicopathologic, and outcome data in 56 women with squamous cell vulvar cancer who developed the disease at age 45 years or younger, to determine whether those patients had different characteristics than others with vulvar cancer.

Nearly 50% of the patients reported the presence of symptoms for less than 6 months prior to diagnosis. The women had excess exposure of tobacco, and almost 70% had a history of vulvar intraepithelial neoplasia (VIN) or cervical intraepithelial neoplasia (CIN). Advanced disease patients were less likely to have had dysplasia, human papilloma virus (HPV), or VIN. Immunocompromised patients were 6.7%.

Patients who underwent modified radical vulvectomy with unilateral or bilateral lymph node dissection were 80%. Among these patients, positive nodes were found in 18%. Women with positive lymph nodes were more likely to have had cervical dysplasia or HPV (p = 0.04) than women with negative lymph nodes.

If we could get women to modify these behaviors, the incidence of vulvar cancer would be decreased, Dr. Judson told Reuters Health. Women, and especially young women, are unaware of vulvar cancer. They are also unaware that cigarette smoking and exposure to the human papilloma virus increases their risk of developing vulvar cancer. The HPV vaccinations will help to decrease the incidence of this cancer.