Trends in HPV-dependent and HPV-independent vulvar cancers: The changing face of vulvar squamous cell carcinoma

Trends in HPV-dependent and HPV-independent vulvar cancers: The changing face of vulvar squamous cell carcinoma

To investigate the incidence and survival of Vulvar Squamous Cell Carcinoma (VSCC) by etiology over a 27 year period. Retrospective case-note and pathology slide review of 390 consecutive VSCC, treated at a Centralized Cancer Centre covering half New Zealand's population, 1990–2016. Incidence w...

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Veröffentlicht in:Gynecologic oncology 2020-05, Vol.157 (2), p.450-455
Hauptverfasser: Eva, Lois J., Sadler, Lynn, Fong, Kah Leng, Sahota, Sukhwinder, Jones, Ronald W., Bigby, Susan M.
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container_end_page 455
container_issue 2
container_start_page 450
container_title Gynecologic oncology
container_volume 157
creator Eva, Lois J.
Sadler, Lynn
Fong, Kah Leng
Sahota, Sukhwinder
Jones, Ronald W.
Bigby, Susan M.
description To investigate the incidence and survival of Vulvar Squamous Cell Carcinoma (VSCC) by etiology over a 27 year period. Retrospective case-note and pathology slide review of 390 consecutive VSCC, treated at a Centralized Cancer Centre covering half New Zealand's population, 1990–2016. Incidence was calculated in 5–6 year cohorts and correlated with precursor of the VSCC, age and stage. Age-standardized incidence of all VSCC did not change significantly, however age standardized incidence of HPV-dependent VSCC increased significantly, from 0.55/100,000 (95% CI 0.38–0.72) in 1991–2000 to 0.83/100,000 (95% CI 0.68–0.97) in 2001–2016, with a significant decrease in the incidence of HPV-independent VSCC, from 0.76/100,000 (95% CI 0.58–0.95) to 0.54/100,000 (95%CI 0.43–0.65). HPV-dependent VSCC in women ≥50 years increased significantly from 0.75/100,000 (95% CI 0.45–1.17) to 1.43/100,000 (95% CI 1.14–1.77), with no significant change seen in younger women. HPV-independent VSCC in women ≥50 years has decreased significantly from 2.53/100,000 (95% CI 1.95–3.23) to 1.62/100,000 (95% CI 1.31–1.98) with no change in younger women. The proportion of HPV-dependent VSCC has increased from 25% to 50%. Age standardized death rate from VSCC has not changed significantly from 0.22/100,000 (95% CI 0.10–0.34) in 2001–5 to 0.27/100,000 (95% CI 0.15–0.40) in 2011–16. Five year survival for HPV-dependent VSCC was 93% and 68% for HPV-independent VSCC (p 
doi_str_mv 10.1016/j.ygyno.2020.01.029
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Retrospective case-note and pathology slide review of 390 consecutive VSCC, treated at a Centralized Cancer Centre covering half New Zealand's population, 1990–2016. Incidence was calculated in 5–6 year cohorts and correlated with precursor of the VSCC, age and stage. Age-standardized incidence of all VSCC did not change significantly, however age standardized incidence of HPV-dependent VSCC increased significantly, from 0.55/100,000 (95% CI 0.38–0.72) in 1991–2000 to 0.83/100,000 (95% CI 0.68–0.97) in 2001–2016, with a significant decrease in the incidence of HPV-independent VSCC, from 0.76/100,000 (95% CI 0.58–0.95) to 0.54/100,000 (95%CI 0.43–0.65). HPV-dependent VSCC in women ≥50 years increased significantly from 0.75/100,000 (95% CI 0.45–1.17) to 1.43/100,000 (95% CI 1.14–1.77), with no significant change seen in younger women. HPV-independent VSCC in women ≥50 years has decreased significantly from 2.53/100,000 (95% CI 1.95–3.23) to 1.62/100,000 (95% CI 1.31–1.98) with no change in younger women. The proportion of HPV-dependent VSCC has increased from 25% to 50%. Age standardized death rate from VSCC has not changed significantly from 0.22/100,000 (95% CI 0.10–0.34) in 2001–5 to 0.27/100,000 (95% CI 0.15–0.40) in 2011–16. Five year survival for HPV-dependent VSCC was 93% and 68% for HPV-independent VSCC (p &lt; .0001). HPV-dependent VSCC incidence has increased significantly and now accounts for half of VSCC, with a significant rise in women over 50. HPV-dependent and independent VSCC have different prognoses and should be registered and investigated separately. •First evidence of incidence of Vulva Squamous Cell Carcinoma by etiology•HPV-dependent VSCC incidence is increasing in older women.•Proportions of HPV-dependent and independent VSCC are now nearly equal.•Five year survival for HPV-dependent VSCC is 93% and 68% for HPV-independent VSCC.•HPV-dependent and independent VSCC should be separated in registries and studies.</description><identifier>ISSN: 0090-8258</identifier><identifier>EISSN: 1095-6859</identifier><identifier>DOI: 10.1016/j.ygyno.2020.01.029</identifier><identifier>PMID: 32037194</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><ispartof>Gynecologic oncology, 2020-05, Vol.157 (2), p.450-455</ispartof><rights>2020 Elsevier Inc.</rights><rights>Copyright © 2020 Elsevier Inc. 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Retrospective case-note and pathology slide review of 390 consecutive VSCC, treated at a Centralized Cancer Centre covering half New Zealand's population, 1990–2016. Incidence was calculated in 5–6 year cohorts and correlated with precursor of the VSCC, age and stage. Age-standardized incidence of all VSCC did not change significantly, however age standardized incidence of HPV-dependent VSCC increased significantly, from 0.55/100,000 (95% CI 0.38–0.72) in 1991–2000 to 0.83/100,000 (95% CI 0.68–0.97) in 2001–2016, with a significant decrease in the incidence of HPV-independent VSCC, from 0.76/100,000 (95% CI 0.58–0.95) to 0.54/100,000 (95%CI 0.43–0.65). HPV-dependent VSCC in women ≥50 years increased significantly from 0.75/100,000 (95% CI 0.45–1.17) to 1.43/100,000 (95% CI 1.14–1.77), with no significant change seen in younger women. HPV-independent VSCC in women ≥50 years has decreased significantly from 2.53/100,000 (95% CI 1.95–3.23) to 1.62/100,000 (95% CI 1.31–1.98) with no change in younger women. The proportion of HPV-dependent VSCC has increased from 25% to 50%. Age standardized death rate from VSCC has not changed significantly from 0.22/100,000 (95% CI 0.10–0.34) in 2001–5 to 0.27/100,000 (95% CI 0.15–0.40) in 2011–16. Five year survival for HPV-dependent VSCC was 93% and 68% for HPV-independent VSCC (p &lt; .0001). HPV-dependent VSCC incidence has increased significantly and now accounts for half of VSCC, with a significant rise in women over 50. 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Retrospective case-note and pathology slide review of 390 consecutive VSCC, treated at a Centralized Cancer Centre covering half New Zealand's population, 1990–2016. Incidence was calculated in 5–6 year cohorts and correlated with precursor of the VSCC, age and stage. Age-standardized incidence of all VSCC did not change significantly, however age standardized incidence of HPV-dependent VSCC increased significantly, from 0.55/100,000 (95% CI 0.38–0.72) in 1991–2000 to 0.83/100,000 (95% CI 0.68–0.97) in 2001–2016, with a significant decrease in the incidence of HPV-independent VSCC, from 0.76/100,000 (95% CI 0.58–0.95) to 0.54/100,000 (95%CI 0.43–0.65). HPV-dependent VSCC in women ≥50 years increased significantly from 0.75/100,000 (95% CI 0.45–1.17) to 1.43/100,000 (95% CI 1.14–1.77), with no significant change seen in younger women. HPV-independent VSCC in women ≥50 years has decreased significantly from 2.53/100,000 (95% CI 1.95–3.23) to 1.62/100,000 (95% CI 1.31–1.98) with no change in younger women. The proportion of HPV-dependent VSCC has increased from 25% to 50%. Age standardized death rate from VSCC has not changed significantly from 0.22/100,000 (95% CI 0.10–0.34) in 2001–5 to 0.27/100,000 (95% CI 0.15–0.40) in 2011–16. Five year survival for HPV-dependent VSCC was 93% and 68% for HPV-independent VSCC (p &lt; .0001). HPV-dependent VSCC incidence has increased significantly and now accounts for half of VSCC, with a significant rise in women over 50. HPV-dependent and independent VSCC have different prognoses and should be registered and investigated separately. •First evidence of incidence of Vulva Squamous Cell Carcinoma by etiology•HPV-dependent VSCC incidence is increasing in older women.•Proportions of HPV-dependent and independent VSCC are now nearly equal.•Five year survival for HPV-dependent VSCC is 93% and 68% for HPV-independent VSCC.•HPV-dependent and independent VSCC should be separated in registries and studies.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32037194</pmid><doi>10.1016/j.ygyno.2020.01.029</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-4239-0313</orcidid></addata></record>
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title Trends in HPV-dependent and HPV-independent vulvar cancers: The changing face of vulvar squamous cell carcinoma
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