Vulval cancer - UK incidence statistics

This page presents incidence statistics for vulval cancer by age, and giving trends over time. There is also information by socio-economic status. The ICD code for vulval cancer is ICD-10 C51.

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In the UK

The vulval site includes the labia majora, labia minora and the clitoris (Figure 1.1).

Figure 1.1: The vulva and vagina

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Cancer of the vulva is not very common and, when coupled with cancer of the vagina, accounts for less than 1% of all cancer cases (excluding non-melanoma skin cancer) and 8% of gynaecological (ovarian, uterine, cervical, vaginal and vulval) cancers diagnosed in women in the UK. In 2008, there were 1,157 new cases of vulval cancer diagnosed in the UK, equating to a European age-standardised incidence rate of 2.5 per 100,000 female population (Table 1.1).1-4  It is estimated that almost 27,000 women worldwide are diagnosed with vulval cancer each year.8 

It has been estimated that the lifetime risk of developing vulval cancer is around 1 in 293 for women in the UK. This was done for 2006-2008 using the AMP method.5

 

Table 1.1: Vulval cancer (C51), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2008

England Wales Scotland Northern Ireland United Kingdom
Cases 973 55 110 19 1,157
Crude Rate 3.7 3.6 4.1 2.1 3.7
AS Rate 2.5 2.3 3.0 1.7 2.5
AS Rate - 95% LCL* 2.3 1.7 2.4 0.9 2.4
AS Rate - 95% UCL* 2.7 3.0 3.5 2.4 2.7

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*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS Rate

Section updated: 16/09/11

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By age

Vulval cancer is very rare in young women aged under 25. Rates are around 1.1 per 100,000 among women aged 25-39, rising to 3.8 per 100,000 in those aged 60-64, and peaking at 24.5 per 100,000 in women aged 85 and over (Figure 1.2). 1-4

Figure 1.2: Vulval cancer (C51), Average Number of New Cases per Year and Age-Specific Incidence Rates, UK, 2006-2008

cases_crude_vulval1.swf

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Section updated: 16/09/11

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Trends over time

Generally, the trend for the incidence rate for vulval cancer has stayed fairly stable over the past 30 years, at around 2.5 per 100,000 women. In contrast, the mortality rate for vulval cancer has almost halved over the time period (Figure 1.3). 1-4

Figure 1.3: Vulval cancer (C51), European Age-Standardised Incidence and Mortality Rates, Great Britain, 1975-2008

inc_mort_asr_vulval.swf

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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 just under 7% in the mid 1970s to 14% in 2006-2008. 1-4 A similar trend has been documented in other countries, 6, 7 and has been linked to increasing incidence of vulval intraepithelial neoplasia (VIN) in young women caused by infection with HPV.7

Figure 1.4 shows the vulval cancer incidence trend for the UK.

Figure 1.4: Vulval cancer (C51), European Age-Standardised Incidence Rates, UK, 1993-2008

inc_asr_uk_vulval.swf

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Section updated: 16/09/11

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Socio-economic status

Several case-control studies have reported an increased risk of vulval cancer associated with lower socio-economic status and fewer years of education. 9-13

Section updated: 31/12/09

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Histology

Squamous cell carcinomas (SCC) account for more than 90% of vulval cancers. 14 The other 10% includes melanomas, sarcomas,  basal cell carcinomas and adenocarcinomas.15

Section updated: 31/12/09

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Pre-cancerous lesions 

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. These are HPV-related tumours, which precede almost all vulval cancers in women under 45; and lichen sclerosus-related tumours, which are the major cause of vulval cancer in older women. 16, 17

Section updated 31/12/09

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References for vulva cancer incidence

  1.  ISD Scotland Online Cancer Registrations in Scotland, 2011.
  2.  Cancer Registrations in Northern Ireland, 2011 Northern Ireland Cancer Registry
  3.  Office for National Statistics, 2011 Cancer Statistics registrations: registrations of cancer diagnosed in 2008, England.  (PDF 544KB)
  4.  Cancer Registrations in Wales, 2010 Welsh Cancer Intelligence and Surveillance Unit
  5.  Sasieni PD, Shelton J, Ormiston-Smith N, Thomson CS, Silcocks PB  What is the lifetime risk of developing cancer?: the effect of adjusting for multiple primaries. Br J Cancer, 2011. 105(3): p. 460-5.
  6.  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
  7.  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
  8.  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
  9.  Parazzini, F., et al., Selected food intake and risk of vulvar cancer. Cancer, 1995. 76(11): p. 2291-6
  10.  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
  11.  Brinton, L.A., et al., Case-control study of cancer of the vulva. Obstet Gynecol, 1990. 75(5): p. 859-66
  12.  Trimble, C.L., et al., Heterogeneous etiology of squamous carcinoma of the vulva. Obstet Gynecol, 1996. 87(1): p. 59-64
  13.  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
  14.  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.
  15.  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.
  16.  Ridley, C.M., The aetiology of vulval neoplasia. Br J Obstet Gynaecol, 1994. 101(8): p. 655-7
  17.  Canavan, T.P. and D. Cohen, Vulvar cancer. Am Fam Physician, 2002. 66(7): p. 1269-74