651 Rising Incidence of Vulval Cancer in Young Women in South East England 1962–1997

Aim: to study age related trends in the incidence of vulval cancer in South East England between 1962 and 1997 Background There has been a rise in predisposing factors for vulval cancer in recent times, leading to an expectation that its incidence may have increased over the last thirty years. to test this theory, age-related incidence rates for vulval cancer in the study period were analysed. Method: Data on the numbers and rates of vulval cancer per five year age group per 100,000 women in the 35 year period from 1962 to 1997 were obtained from the Thames Cancer Registry. Changes in the incidence rate of vulval cancer over time were determined by linear regression. Results: in women aged 30-35 there was a small but significant increase in incidence of vulval cancer; this increased by 0.054 per 100,000 women in each five year calendar period (95% CI 0.026-0.082 per 100,000 women, p = 0.013). in women over 85 years there was a marginally significant rise in incidence (95% CI 0.287-4.374 per 100,000 women, p = 0.076). The overall incidence in all age-groups combined remained unchanged. Conclusion: These observations would support the theory that incidence rates of vulval cancer are influenced by rising rates of vulval intraepithelial neoplasia, infection by oncogenic human papilloma virus, human immunodeficiency virus and other sexually transmitted diseases. These conditions, as well as life style and behavioural changes that predispose to vulval cancer occur particularly in younger women. This would have potential implications for the provision and planning of cancer services.