A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian Indigenous women
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To describe the epidemiological features of a possible disease cluster of vulvar cancer and pre-cancers in Australian Indigenous women living in the Northern Territory (NT) of Australia.
We identified NT-resident women with a confirmed histological diagnosis of vulvar cancer or high-grade vulvar intraepithelial neoplasia (VIN) between 1 January 1996 and 31 December 2005.
Seventy-one women were identified; 32 diagnosed with vulvar cancer and 39 with high-grade VIN. Most women diagnosed were Indigenous, aged less than 50 years and living in remote communities in the East Arnhem (EA) district, on the north-east coast of the NT. The age-adjusted incidence rate of vulvar cancer in EA Indigenous women aged 0–49 years was 31.1 per 100,000 (95% CI 13.1–49.1), over 50 times higher than the national Australian rate (0.4 per 100,000, 95% CI 0.4–0.5) for the same age-group. In the age-group of 0–49 years, the age-adjusted incidence rate of VIN for EA Indigenous women was 34.7 per 100,000 (95% CI 15.2–54.3), compared with 6.7 per 100,000 (95% CI 2.0–11.4) for Indigenous women living elsewhere in the Top End of the NT.
These data provide evidence of a geographic cluster of vulvar cancer in remote Indigenous communities in northern Australia.
KeywordsVulvar neoplasms Ethnology Incidence
We are grateful to Dr. Steve Guthridge, Ms. Debbie Taylor-Thomson, and staff of the Health Gains Planning Branch of the Northern Territory Department of Health and Community Services (NTDHCS), and Northern Territory Hospitals for advice and assistance during data collection and analysis. We thank Dr. Tom Dodds, Institute of Medical and Veterinary Science, Adelaide, for providing a second opinion of cases of vulvar cancer. Financial support: Funding for this study was provided by the NT DHCS. Alice Rumbold and John Condon were supported by a National Health and Medical Research Council Capacity Building Grant #236235.
Conflicts of interest
We are not aware of any financial or other conflicts of interest.
- 1.Parkin DM, Whelan SL, Ferlay J, Teppo L, Thomas DB (eds) (2002) Cancer incidence in five continents, vol VIII. International Agency for Research on Cancer, Lyon, FRAGoogle Scholar
- 2.National Cancer Statistics Clearing House (2003) Interactive cancer data. Australian Institute of Health and Welfare, Canberra, AustraliaGoogle Scholar
- 10.Australian Bureau of Statistics and Australian Institute of Health and Welfare (2005) The health and welfare of Australia’s Aboriginal and Torres Strait islander peoples. Australian Bureau of Statistics and Australian Institute of Health and Welfare, Canberra, AustraliaGoogle Scholar
- 12.Chondour R, Guthridge S (2006) Population data in the Northern Territory. Department of Health and Community Services, Darwin, AustraliaGoogle Scholar
- 15.Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJL, Lozano R, Inoue I (2006) Age standardization rates: a new WHO standard (Discussion paper on the internet). World Health Organisation; GPE Discussion Paper Series: No. 31 (cited 20 Dec 2006). Available from: http://www.emro.who.int/ncd/publications/WHO_pop_standard.pdf
- 17.van Beurden M, ten Kate FJ, Smits HL et al (1995) Multifocal vulvar intraepithelial neoplasia grade III and multicentric lower genital tract neoplasia is associated with transcriptionally active human papillomavirus. Cancer 75:2879–2884. doi: 10.1002/1097-0142(19950615)75:12<2879::AID-CNCR2820751214>3.0.CO;2-W PubMedCrossRefGoogle Scholar
- 21.Cunningham J (1997) Occasional paper: cigarette smoking among Indigenous Australians. Australian Bureau of Statistics, Canberra, AustraliaGoogle Scholar
- 22.Carter J, Carlson J, Fowler J et al (1993) Invasive vulvar tumors in young women—a disease of the immunosuppressed? Gynecol Oncol 75:2879–2884Google Scholar
- 27.Jones C, Zhang X, Dempsey K et al (2005) The health and wellbeing of Northern Territory women: from the desert to the sea. Department of Health and Community Services, Darwin, AustraliaGoogle Scholar
- 28.Australian Bureau of Statistics (2006) National health survey: summary of results, Australia 2004–05. Australian Bureau of Statistics, Canberra, AustraliaGoogle Scholar
- 29.National Centre in HIV Epidemiology and Clinical Research (2006) HIV/AIDS, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2006. National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales and the Australian Institute of Health and Welfare, Canberra, AustraliaGoogle Scholar
- 34.Garland SM, Hernandez-Avila M, Wheeler CM et al for the Females United to Unilaterally Reduce Endo/Ectocervical Disease (FUTURE) I Investigators (2007) Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med 356:1928–1943. doi: 10.1056/NEJMoa061760 Google Scholar