Vulvar intraepithelial neoplasia: Incidence and long-term risk of vulvar squamous cell carcinoma.
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma in Situ
/ diagnosis
Carcinoma, Squamous Cell
/ diagnosis
Disease Progression
Female
Follow-Up Studies
Humans
Incidence
Middle Aged
Netherlands
/ epidemiology
Precancerous Conditions
/ diagnosis
Risk Factors
Squamous Intraepithelial Lesions
/ diagnosis
Vulva
/ pathology
Vulvar Neoplasms
/ diagnosis
Young Adult
HSIL
dVIN
incidence
vulvar intraepithelial neoplasia
vulvar squamous cell carcinoma
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
received:
06
04
2020
revised:
15
06
2020
accepted:
25
06
2020
pubmed:
9
7
2020
medline:
11
6
2021
entrez:
9
7
2020
Statut:
ppublish
Résumé
The risk of vulvar squamous cell carcinoma (VSCC) in patients with high-grade vulvar intraepithelial neoplasia (VIN) is considered lower in high-grade squamous intraepithelial lesion (HSIL) compared to differentiated VIN (dVIN), but studies are limited. Our study investigated both the incidence of high-grade VIN and the cumulative incidence of VSCC in patients with HSIL and dVIN separately. A database of women diagnosed with high-grade VIN between 1991 and 2011 was constructed with data from the Dutch Pathology Registry (PALGA). The European standardized incidence rate (ESR) and VSCC risk were calculated, stratified for HSIL and dVIN. The effects of type of VIN (HSIL vs dVIN), age and lichen sclerosis (LS) were estimated by Cox regression. In total, 1148 patients were diagnosed with high-grade VIN between 1991 and 2011. Between 1991-1995 and 2006-2011, the ESR of HSIL increased from 2.39 (per 100 000 woman-years) to 3.26 and the ESR of dVIN increased from 0.02 to 0.08. The 10-year cumulative VSCC risk was 10.3%; 9.7% for HSIL and 50.0% for dVIN (log rank P < .001). Type of VIN, age and presence of LS were independent risk factors for progression to VSCC, with hazard ratios of 3.0 (95% confidence interval [CI] 1.3-7.1), 2.3 (95% CI 1.5-3.4) and 3.1 (95% CI 1.8-5.3), respectively. The incidence of high-grade VIN is rising. Because of the high cancer risk in patients with dVIN, better identification and timely recognition are urgently needed.
Identifiants
pubmed: 32638382
doi: 10.1002/ijc.33198
pmc: PMC7689827
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
90-98Informations de copyright
© 2020 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of Union for International Cancer Control.
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