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Changing Trends in Vulvar Cancer Incidence and Mortality Rates in Australia Since 1982

Barlow, Ellen L. RN, BN, MN (Hons)*; Kang, Yoon-Jung BA, MPH (Hons), PhD; Hacker, Neville F. AM, MD FRANZCOG‡§; Canfell, Karen DPhil

International Journal of Gynecological Cancer: November 2015 - Volume 25 - Issue 9 - p 1683–1689
doi: 10.1097/IGC.0000000000000547
Vulvar

Background: The objective of this study was to assess trends in vulvar cancer incidence and mortality in Australia.

Methods: Case numbers for invasive carcinoma of the vulva (1982–2009) and vulvar cancer deaths (1982–2011) were obtained from the National Cancer Statistics database. Standardized rate ratios (SRRs) were used to assess changes in age-standardized incidence and mortality rates, for all ages and for younger than 60 years and 60+ years.

Results: Age-standardized incidence rates in women across all ages did not significantly change from 1982–1984 to 2007–2009 (from 2.1 to 2.5 per 100,000 women; SRR from the later to the earlier period, 1.13 [95% CI, 1.00–1.27]). However, there was a significant 84% increase in incidence in women younger than 60 years (SRR, 1.84 [95% CI, 1.49–2.26]), with no change for women 60+ years (SRR, 0.90 [95% CI, 0.79–1.04]). Age-standardized mortality in women across all ages significantly decreased by 22% from 1982–1986 to 2007–2011 (from 0.7 to 0.5 per 100,000 women; SRR, 0.78 [95% CI, 0.66–0.93]). However, this was driven by declines in older women, with stable rates in women younger than 60 years (SRR, 1.05 [95% CI, 0.62–1.79]); rates in 60+ years decreased by 24% (SRR, 0.76 [95% CI, 0.63–0.91]).

Conclusion: Since the early 1980s, vulvar cancer incidence has increased by more than 80% in women younger than 60 years in Australia, but there has been no increased incidence in older women. These findings are consistent with the possibility of increased exposure to the human papillomavirus in cohorts born after 1950. By contrast, age-standardized vulvar cancer mortality rates have been stable in younger women, but have declined in older women.

*Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, NSW, Australia; †Cancer Screening Group, Lowy Cancer Research Centre, Prince of Wales Clinical School, UNSW, Randwick, NSW, Australia; ‡Gynaecological Cancer Centre, Royal Hospital for Women, Randwick, NSW, Australia; and §School of Women’s & Children’s Health, University of New South Wales, Randwick, NSW, Australia.

Address correspondence and reprint requests to Ellen L. Barlow, RN, BN, MN (Hons), Gynaecological Cancer Centre, The Royal Hospital for Women, Locked Bag 1000, Barker St, Randwick, 2031 NSW, Australia. E-mail: ellen.barlow@sesiahs.health.nsw.gov.au.

Competing interests: K.C. is co–principal investigator of a trial of primary human papillomavirus screening for cervical cancer in Victoria (“Compass”), which is conducted and funded by the Victorian Cytology Service. A funding and equipment contribution for the trial has been received by Victorian Cytology Service from Roche Molecular Systems and Ventana Inc, USA.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Current affiliation for Dr Yoon-Jung Kang and Associate Professor Karen Canfell is Cancer Research Division, Cancer Council of NSW, Woolloomooloo, NSW, Australia.

Received April 25, 2015

Received in revised form July 5, 2015

Accepted July 5, 2015

© 2015 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.