Skip to main content

Advertisement

Log in

Epidemiology of vulvar and vaginal cancer in Germany

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Vulvar and vaginal cancers are rare diseases with an incidence rate that increases with age. At present, epidemiological data are rather scarce. This review article provides an epidemiologic overview of these diseases, focussing on recent German data.

Methods

This review article summarizes the information currently available in order to offer an epidemiologic overview.

Results

The statistic incidence of vulvar carcinoma has been calculated between 2 and 7 cases per 100,000 women, and that of vaginal carcinoma 0.6–1.0 cases per 100,000 women. These incidence rates, especially concerning intraepithelial neoplasm, have increased heavily since the 1970s. The mean age of vulvar cancer affection is 72 years, and 74 years for vaginal carcinoma. In the case of women below the age of 50, cancer tends to be HPV-associated which implies a coincidence of about 20% for cervical and anal cancer. Various pathological mechanisms are the cause for women above the age of 50.

Conclusions

Due to a change in sexual behavior and an increased rate of HPV infection among younger women, increased incidence of both diseases has to be expected. The age-standardized mortality rate of vulvar carcinoma in Europe is stated at 0.7/100,000 women, and that of vaginal carcinoma at 0.4/100.000 women. To what extent the HPV-vaccination affects incidence and mortality rates is continually being observed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Judson PL, Habermann EB, Baxter NN et al (2006) Trends in the incidence of invasive and in situ vulvar carcinoma. Obstet Gynecol 107(5):1018–1022

    Article  PubMed  Google Scholar 

  2. Sturgeon SR, Curtis RE, Johnson K et al (1996) Second primary cancers after vulvar and vaginal cancer. AMJ Obstet Gynecol 174(3):929–933

    Article  CAS  Google Scholar 

  3. Joura EA, Lösch A, Haider-Angeler MG et al (2000) Trends in vulvar neoplasia. Increasing incidence of vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women. J Reprod Med 45(8):613–615

    PubMed  CAS  Google Scholar 

  4. Brinton LA, Nasca PC, Mallin K et al (1990) Case–control study of cancer of the vulva. Obstet Gynecol 75(5):859–866

    PubMed  CAS  Google Scholar 

  5. Daling JR, Sherman KJ, Hislop TG et al (1992) Cigarette smoking and the risk of anogenital cancer. Am J Epidemiol 135(2):180–189

    PubMed  CAS  Google Scholar 

  6. Sturgeon SR, Brinton LA, Devesa SS et al (1992) In situ, invasive vulvar cancer incidence trends (1973 to 1987). Am J Obstet Gynecol 166(5):1482–1485

    PubMed  CAS  Google Scholar 

  7. Madeleine MM, Daling JR, Carter JJ et al (1997) Cofactors with human papillomavirus in a population-based study of vulvar cancer. J Natl Cancer Inst 89(20):1516–1523

    Article  PubMed  CAS  Google Scholar 

  8. http://www.tumorregister-muenchen.de

  9. Santos M, Montagut C, Mellado B et al (2004) Immunohistochemical staining for p16 and p53 in premalignant and malignant epithelial lesions of the vulva. Int J Gynecol Pathol 23(3):206–214

    Article  PubMed  Google Scholar 

  10. Informationszentrum für Standards in der Onkologie—ISTO: Interdisziplinäre Kurzgefasste Leitlinien der Deutschen Krebsgesellschaft und der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe, AWMF-Leitlinienregister 032-032, 2001

  11. Sankaranarayanan R, Ferlay J (2006) Worldwide burden of gynaecological cancer: the size of the problem. Best Pract Res Clin Obstet Gynaecol 20(2):207–225

    Article  PubMed  CAS  Google Scholar 

  12. Mandelblatt JS, Kanetsky P, Eggert L et al (1999) Is HIV infection a cofactor for cervical squamous cell neoplasia? Cancer Epidemiol Biomarkers Prev 8(1):97–106

    PubMed  CAS  Google Scholar 

  13. Engel J, Schmidt M, Schubert-Fritschle G (Hrg.) Tumorregister München: Jahresbericht 1999, Zuckschwerdt Verlag Germering

  14. Al-Ghamdi A, Freedman D, Miller D et al (2002) Vulvar squamous cell carcinoma in young women: a clinicopathologic study of 21 cases. Gynecol Oncol 84(1):94–101

    Article  PubMed  CAS  Google Scholar 

  15. Hording U, Daugaard S, Junge J et al (1996) Human papillomaviruses and multifocal genital neoplasia. Int J Gynecol Pathol 15(3):230–234

    Article  PubMed  CAS  Google Scholar 

  16. Bjørge T, Dillner J, Anttila T et al (1997) Prospective seroepidemiological study of role of human papillomavirus in non-cervical anogenital cancers. BMJ. 315(7109):646–649

    PubMed  Google Scholar 

  17. Santos M, Landolfi S, Olivella A et al (2004) p16 overexpression identifies HPV-positive vulvar squamous cell carcinomas. Am J Surg Pathol 30(11):1347–1356

    Google Scholar 

  18. Sigvardsson S, Hardell L, Przybeck TR et al (1996) Increased cancer risk among Swedish female alcoholics. Epidemiology 7(2):140–143

    Article  PubMed  CAS  Google Scholar 

  19. Daling JR, Chu J, Weiss NS et al (1984) The association of condylomata acuminata and squamous carcinoma of the vulva. Br J Cancer 50(4):533–535

    Article  PubMed  CAS  Google Scholar 

  20. Koyamatsu Y, Yokoyama M, Nakao Y et al (2003) A comparative analysis of human papillomavirus types 16 and 18 and expression of p53 gene and Ki-67 in cervical, vaginal, and vulvar carcinomas. Gynecol Oncol 90(3):547–551

    Article  PubMed  CAS  Google Scholar 

  21. Rolfe KJ et al (2003) TP53 mutations in vulval lichen sclerosus adjacent to squamous cell carcinoma of the vulva. Br J Cancer 89(12):2249–2253

    Article  PubMed  CAS  Google Scholar 

  22. Mardh PA (1991) The vaginal ecosystem. Am J Obstet Gynecol 165:1163–1168

    PubMed  CAS  Google Scholar 

  23. Ries LAG, Kossary CL, Hankey BF et al (1998) SEER Cancer statistics Review, 1973–1995. National Cancer Institute, Bethesda

    Google Scholar 

  24. http://www.destatis.de

  25. Beller U, Sideri M, Maisonneuve P et al (2001) Carcinoma of the vagina. J Epidemiol Biostat 6(1):141–152

    PubMed  CAS  Google Scholar 

  26. Fu YS (2002) Pathology of the uterine cervix, vagina, and vulva, 2nd edn. Saunders, Philadelphia, p 531

    Google Scholar 

  27. Creasman WT, Phillips JL, Menck HR (1998) The National cancer data base report on cancer of the vagina. Cancer 83:1033

    Article  PubMed  CAS  Google Scholar 

  28. Herbst AL, Ulfelder H, Poskanzer DC et al (1991) Adenocarcinoma of the vagina. Association of maternal stilbestrol therapy with tumor appearance in young women. 1971. Am J Obstet Gynecol 181(6):1574–1575

    Article  Google Scholar 

  29. Carter JJ et al (2001) Human papillomavirus 16 and 18 L1 serology compared across anogenital cancer sites. Cancer Res 61(5):1934–1940

    PubMed  CAS  Google Scholar 

  30. Daling JR, Madeleine MM, Schwartz SM et al (2002) A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecol Oncol 84(2):263–270

    Article  PubMed  CAS  Google Scholar 

  31. Hampl M et al (2006) Effect of human papillomavirus vaccines on vulvar, vaginal, and anal intraepithelial lesions and vulvar cancer. Obstet Gynecol 108(6):1361–1368

    Article  PubMed  CAS  Google Scholar 

  32. Madsen BS et al (2008) Risk factors for invasive squamous cell carcinoma of the vulva and vagina–population-based case-control study in Denmark. Int J Cancer 122(12):2827–2834

    Article  PubMed  CAS  Google Scholar 

  33. Wassberg C et al (1999) Second primary cancers in patients with squamous cell carcinoma of the skin: a population-based study in Sweden. Int J Cancer 80(4):511–515

    Article  PubMed  CAS  Google Scholar 

  34. Benedet JL, Murphy KJ, Fairey RN et al (1983) Primary invasive carcinoma of the vagina. Obstet Gynecol 62(6):715–719

    PubMed  CAS  Google Scholar 

  35. Eddy GL, Marks RD, Miller MC et al (1991) Primary invasive vaginal carcinoma. Am J Obstet Gynecol 165(2):292–296

    PubMed  CAS  Google Scholar 

  36. Frisch M, Olsen JH, Melbye M (1994) Malignancies that occur before and after anal cancer: clues to their etiology. Am J Epidemiol 140(1):12–19

    PubMed  CAS  Google Scholar 

  37. Hussain SK et al (2008) Familial clustering of cancer at human papillomavirus-associated sites according to the Swedish family-cancer database. Int J Cancer 122(8):1873–1878

    Article  PubMed  CAS  Google Scholar 

  38. Parazzini F et al (1995) Selected food intake and risk of vulvar cancer. Cancer 76(11):2291–2296

    Article  PubMed  CAS  Google Scholar 

  39. Basta A, Adamek K, Pitynski K (1999) Intraepithelial neoplasia and early stage vulvar cancer. Epidemiological, clinical and virological observations. Eur J Gynaecol Oncol 20(2):111–114

    PubMed  CAS  Google Scholar 

  40. Trimble CL et al (1996) Heterogeneous etiology of squamous carcinoma of the vulva. Obstet Gynecol 87(1):59–64

    Article  PubMed  CAS  Google Scholar 

  41. Baumann KH, Müller O, Naujok HB et al (2010) Small-area analysis of incidence and localisation of vulvar cancer. J Oncol 2010:512032

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Dittmer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dittmer, C., Katalinic, A., Mundhenke, C. et al. Epidemiology of vulvar and vaginal cancer in Germany. Arch Gynecol Obstet 284, 169–174 (2011). https://doi.org/10.1007/s00404-011-1850-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-011-1850-9

Keywords

Navigation