
UK Vulva Cancer incidence statistics
This page presents vulval cancer incidence statistics by age, trends
over
time, geographical variation and socio-economic status. The ICD code for vulval cancer is ICD9 184.4 and ICD10 C51.
The vulva site includes the labia majora, labia minora and
the
clitoris (Figure 1.1).

Download this image (46KB)
Back to top ^
Cancer of the vulva is rare and, when coupled with cancer of the vagina, accounts for less than 1% of all cancer cases (excluding
non-melanoma
skin cancer) and 6% of gynaecological cancers in
the UK.
Incidence rates for vulval cancer in younger women
have doubled in the last three decades, survival rates have
improved over the last 30 years. This has resulted in a fall in mortality rates.
Infection with
the human papillomavirus (HPV) is a major cause of vulval cancers, along with smoking. Unlike
other reproductive tract cancers – with the exception of vaginal and cervical cancer
–
risk of vulval cancer is not related to reproductive factors or exogenous hormones.
In 2004, 1,022 new cases of vulval cancer were
diagnosed.(Table 1.1).1-4 The
European age-standardised incidence rate of vulval cancer in the UK is around 2 per 100,000 female
population.1-4

Download this table (21KB)
Back to top ^
Vulval cancer incidence by age
Vulval cancer is very rare in young women aged under 25. Rates are less than 1 per 100,000 among women aged
25–44, rising to 3 per 100,000 in those aged 45–64, and peak at 14 per 100,000 in women aged 65 and over
(Figure
1.2).1-4

Download this chart (16.5KB)
Back to top ^
Vulval cancer incidence trends
While there were slight falls in the incidence of vulval cancer between 1975 and the mid-1980s, increases
since
the mid-1990s mean that incidence has now reached a similar level to that of 1975 (Figure
1.3).1-4

Download this chart (16.5KB)
Back to top ^
There has been a significant increase in rates of vulval cancer in younger women. The proportion of cases
diagnosed under the age of 50 rose from 6% in 1975 to 11% in 2004.1-4A similar trend has been documented in other
countries, 5,6 and has been linked to increasing incidence of vulval
intraepithelial neoplasia (VIN) in young women caused by infection with HPV.6
Figure 1.4 shows the vulval cancer incidence trend for the UK.

Download this chart (16.5KB)
Geographical variation in vulval cancer incidence
It is estimated that almost 27,000 women worldwide are diagnosed with vulval cancer each year.7
Rates range from less than 0.3 per 100,000 females in parts of Asia to about 1.6 per 100,000 females in
north
America and Europe ( Figure 1.4).7 This variation is
probably related to differing prevalence of HPV infection in world regions, and other lifestyle factors,
especially
smoking, and
their interaction with HPV (see Risk factors).

Download this chart (16KB)
Back to top ^
Socio-economic status and vulval cancer incidence
Several case-control studies have reported an
increased risk of vulval cancer associated with lower socio-economic status and fewer years of education.8-14
Vulval cancer histology
Squamous cell carcinomas (SCC) account for more than 90% of vulval cancers.15 The other 10% includes melanomas, sarcomas, basal cell carcinomas and adenocarcinomas.16
Pre-cancerous lesions of the vulva
A substantial proportion of vulval invasive tumours are found with adjacent evidence of pre-cancers, known
collectively as vulval intraepithelial neoplasia (VIN).
There are two main types of VIN. HPV-related, which precedes almost all vulval cancers in women under 45,
and
lichen sclerosus-related, the major cause of vulval
cancer in older women.17,18
The classification system for VIN changed in 2004 to better reflect the two divergent types of lesions (Table 1.2).19,20

Download this table (19.5KB)
Back to top ^
Annual risk of invasive vulval cancer in women with untreated carcinoma in situ (high-grade VIN) of the vulva is at least 10%, while risk of
progression in
treated lesions over a period of years is between 2% and 5%.21 The
absolute risk for women treated for lichen sclerosus is at the top end of this range,20 and relative risks greater than 300 have been reported for vulval SCC in women who
have
undergone treatment.22,23
References for vulva cancer incidence
- ISD Scotland
Online Cancer Registrations in Scotland.
- Cancer Registrations in Northern Ireland Northern Ireland Cancer
Registry
- Cancer Registrations in England, 2004 Office for
National Statistics
- Cancer Registrations in Wales Welsh Cancer
Intelligence and Surveillance
Unit
- Jones, R.W., J. Baranyai, and S. Stables,Trends in squamous cell carcinoma of the vulva: the
influence
of vulvar intraepithelial neoplasia. Obstet Gynecol, 1997. 90(3): p. 448-52
- Joura, E.A., et al.,Trends in vulvar neoplasia. Increasing incidence
of
vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women. J Reprod Med,
2000.
45(8): p. 613-5
- Sankaranarayanan, R. and J. Ferlay,Worldwide burden of gynaecological cancer: the size of the
problem. Best Pract Res Clin Obstet Gynaecol, 2006. 20(2): p. 207-25
- Parazzini, F., et al.,Selected food intake and risk of vulvar cancer. Cancer,
1995. 76(11): p. 2291-6
- Newcomb, P.A., N.S. Weiss, and J.R. Daling,Incidence of vulvar carcinoma in relation to menstrual,
reproductive, and medical factors. J Natl Cancer Inst, 1984. 73(2): p. 391-6
- Basta, A., K. Adamek, and K. Pitynski,Intraepithelial neoplasia and early stage vulvar cancer.
Epidemiological, clinical and virological observations. Eur J Gynaecol Oncol, 1999. 20(2): p. 111-4
- Brinton, L.A., et al.,Case-control study of cancer of the vulva. Obstet
Gynecol,
1990. 75(5): p. 859-66
- Trimble, C.L., et al.,Heterogeneous etiology of squamous carcinoma of the
vulva.
Obstet Gynecol, 1996. 87(1): p. 59-64
- Hildesheim, A., et al.,Human papillomavirus type 16 and risk of preinvasive and
invasive vulvar cancer: results from a seroepidemiological case-control study. Obstet Gynecol, 1997. 90(5):
p.
748-54
- Daling, J.R., et al.,A population-based study of squamous cell vaginal cancer:
HPV
and cofactors. Gynecol Oncol, 2002. 84(2): p. 263-70
- Woolas, R.P. and J.H. Shepherd, Current developments in the management of
vulval
carcinoma, in The Yearbook of Obstetrics and Gynecology, P.M.S. O'Brien, Editor. 1999, RCOG Press.
- Daling, J.R. and J.H. Sherman, Cancers of the vulva and vagina, in Cancer
epidemiology and prevention D. Schottenfeld and J. Fraumeni Jr, Editors. 1996, OUP: Oxford. p. 1117-1129.
- Ridley, C.M.,The aetiology of vulval neoplasia. Br J Obstet
Gynaecol,
1994. 101(8): p. 655-7
- Canavan, T.P. and D. Cohen,Vulvar cancer. Am Fam Physician, 2002. 66(7): p.
1269-74
- Sideri, M., et al.,Squamous vulvar intraepithelial neoplasia: 2004 modified
terminology, ISSVD Vulvar Oncology Subcommittee. J Reprod Med, 2005. 50(11): p. 807-10
- Perrett, C.W., The molecular biology of lichen sclerosus and the development
of
cancer, in Lower Genital Tract Neoplasia, A.B. MacLean, A. Singer, and H. Critchley, Editors. 2003, RCOG Press:
London.
- Jones, R.W.,Vulval intraepithelial neoplasia: current
perspectives.
Eur J Gynaecol Oncol, 2001. 22(6): p. 393-402
- Carli, P., et al.,Squamous cell carcinoma arising in vulval lichen sclerosus:
a
longitudinal cohort study. Eur J Cancer Prev, 1995. 4(6): p. 491-5
- Scurry, J.P. and K. Vanin,Vulvar squamous cell carcinoma and lichen sclerosus.
Australas J Dermatol, 1997. 38 Suppl 1: p. S20-5
Back to top ^
Select the cancer you are interested in
Page last updated:
September 2007