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Vulval cancer: prevention and screening
1Department of Obstetrics and Gynaecology, Royal Free Campus, Royal Free and University College, Rowland Hill Street, Hampstead, London NW3 2PF, UK. amaclean@medsch.ucl.ac.uk
Best Practice & Research. Clinical Obstetrics & Gynaecology
|March 18, 2006
Summary
Vulval cancer incidence is increasing in all age groups. Understanding risk factors for lichen sclerosus (LS) and vulval intraepithelial neoplasia (VIN) is crucial for prevention and early detection.
Area of Science:
- Gynecologic Oncology
- Dermatology
- Pathology
Background:
- Vulval cancer incidence is rising in both older women and those under 50.
- Vulval cancer presents at least two distinct types, associated with lichen sclerosus (LS) and vulval intraepithelial neoplasia (VIN).
- Current understanding of VIN terminology has been recently updated.
Purpose of the Study:
- To review recent pathological and etiological descriptions of vulval cancer.
- To highlight the need for understanding risk factors in LS and VIN for improved prevention and screening.
- To discuss potential future contributions of molecular studies to risk assessment.
Main Methods:
- Review of recent pathological and etiological literature.
- Description of vulval cytology and toluidine blue staining techniques.
- Discussion of clinical features and patient awareness.
Main Results:
- Vulval cancer affects diverse age groups, with increasing incidence.
- Two main etiological pathways for vulval cancer involve LS and VIN.
- Clinical presentation of vulval cancer can be non-specific.
Conclusions:
- Greater understanding of molecular changes in LS and VIN is needed to identify high-risk individuals.
- Vulval cytology and toluidine blue staining are diagnostic tools.
- Future prevention strategies may include HPV vaccination and smoking cessation campaigns.
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