Age-associated trends of vulvar cancer in the US
| Autor: | Mario R. Castellanos, Sarah Thappa, Marianne Smith, Adi Davidov, Hanaa Khadraoui |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
General Mathematics Uterine Cervical Neoplasms Physical examination Asymptomatic Epidemiology medicine Humans Papillomaviridae Early Detection of Cancer Aged Cervical cancer integumentary system medicine.diagnostic_test Vulvar Neoplasms business.industry Obstetrics Applied Mathematics Mortality rate Incidence (epidemiology) Incidence Obstetrics and Gynecology Cancer Vulvar cancer medicine.disease female genital diseases and pregnancy complications Female medicine.symptom business |
| Zdroj: | Menopause (New York, N.Y.). 28(2) |
| ISSN: | 1530-0374 |
| Popis: | Medical societies have over the years moved away from recommending routine pelvic examinations in older, asymptomatic women above age 65. Consequently, vulvar examination is a largely neglected component of the physical examination, unless sent to a specialist for gynecological evaluation. In recognition of these recommendations, we analyzed US trends in vulvar cancer incidence, age, and stage at diagnosis, survival, and association with human papillomavirus (HPV).Cases of vulvar and cervical cancer from 1992 to 2014 were extracted from the National Cancer Institute's Surveillance, Epidemiology, and End Results and Centers for Disease Control's data on age at diagnosis, stage of disease, and HPV-association were analyzed and compared. Incidence and mortality rates were extracted and calculated.From 1992-2014, there was a 14.3% increase in vulvar cancer rates. The absolute average incidence rate was 2.25, with HPV still being seen in vulvar carcinomas in women 65 years and above. Cervical cancer mortality rates declined by 34.2%, while vulvar cancer death rates were unchanged. We show increased intervals for cervical cancer screening is associated with later stage vulvar cancer detection. The proportion of vulvar cancer cases diagnosed in women age50 steadily decreased, from 42.05% of cases in 1992-1996 to 19.75% of total cases in 2012-2015. Meanwhile, vulvar cancer cases diagnosed in women65 yo increased from 36.62% of cases in 1992-1996 to 49.82% of cases in 2012-2015.The incidence of vulvar cancer increases with age, with the median age of diagnosis 67 years, with HPV (+) tumors occurring into 70's and 80's. Though medical societies do not routinely recommend an external genital examination in women 65 years and above, we show this is a missed opportunity to improve cancer outcomes in some older females.Video Summary:http://links.lww.com/MENO/A678. |
| Databáze: | OpenAIRE |
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