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{{CMG}}{{AE}}{{MD}} {{sali}}
{{Vulvar cancer}}
{{Vulvar cancer}}


==Overview==
==Overview==
Common risk factors in the development of vulvar cancer are [[human papilloma virus|human papilloma virus (HPV)]], [[human immunodeficiency virus]], vulvar intraepithelial neoplasia, and [[lichen sclerosus]].


==Who is at highest risk?==
==Risk factors==
Clinical data has suggested that the development of vulvar cancer is related to several factors.  
====Known risk factors====
*[[Human papilloma virus]] ([[HPV]])
**Clinical survey shows [[HPV]] infection is thought to be responsible for up to half of vulvar cancers overall and most of the cases that occur in younger women.<ref name="xyz">Risk factors for vulvar cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/risks/?region=ns Accessed on September 27, 2015</ref><ref name="pmid18192968">{{cite journal |vauthors=de Koning MN, Quint WG, Pirog EC |title=Prevalence of mucosal and cutaneous human papillomaviruses in different histologic subtypes of vulvar carcinoma |journal=Mod. Pathol. |volume=21 |issue=3 |pages=334–44 |date=March 2008 |pmid=18192968 |doi=10.1038/modpathol.3801009 |url=}}</ref><ref name="pmid28059099">{{cite journal |vauthors=Halec G, Alemany L, Quiros B, Clavero O, Höfler D, Alejo M, Quint W, Pawlita M, Bosch FX, de Sanjose S |title=Biological relevance of human papillomaviruses in vulvar cancer |journal=Mod. Pathol. |volume=30 |issue=4 |pages=549–562 |date=April 2017 |pmid=28059099 |doi=10.1038/modpathol.2016.197 |url=}}</ref><ref name="pmid28377483">{{cite journal |vauthors=Weberpals JI, Lo B, Duciaume MM, Spaans JN, Clancy AA, Dimitroulakos J, Goss GD, Sekhon HS |title=Vulvar Squamous Cell Carcinoma (VSCC) as Two Diseases: HPV Status Identifies Distinct Mutational Profiles Including Oncogenic Fibroblast Growth Factor Receptor 3 |journal=Clin. Cancer Res. |volume=23 |issue=15 |pages=4501–4510 |date=August 2017 |pmid=28377483 |doi=10.1158/1078-0432.CCR-16-3230 |url=}}</ref><ref name="pmid28236455">{{cite journal |vauthors=Brinton LA, Thistle JE, Liao LM, Trabert B |title=Epidemiology of vulvar neoplasia in the NIH-AARP Study |journal=Gynecol. Oncol. |volume=145 |issue=2 |pages=298–304 |date=May 2017 |pmid=28236455 |pmc=5629039 |doi=10.1016/j.ygyno.2017.02.030 |url=}}</ref>


:*Human papilloma virus (HPV): Clinical survey shows HPV infection is thought to be responsible for up to half of vulvar cancers overall, and most of the cases that occur in younger women.
*[[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]] ([[HIV]])
:*Human immunodeficiency virus (HIV): Scientists found that HIV can damage the body's immune system and make women more susceptible to persistent HPV infections.  
** Scientists found that [[HIV]] can damage the body's [[Immune systems|immune system]] and make women more susceptible to persistent [[HPV]] infections.  
:*Vulvar intraepithelial neoplasia (VIN): Clinical data suggest that women with VIN have an increased risk of developing invasive vulvar cancer.
*[[Vulvar intraepithelial neoplasia]] (VIN)
:*Lichen sclerosus (LS): Epidemiological data show about 4% of women with LS develope vulvar cancer later.  
**Clinical data suggest that women with VIN have an increased risk of developing invasive vulvar cancer.<ref name="pmid26974999">{{cite journal |vauthors=Bigby SM, Eva LJ, Fong KL, Jones RW |title=The Natural History of Vulvar Intraepithelial Neoplasia, Differentiated Type: Evidence for Progression and Diagnostic Challenges |journal=Int. J. Gynecol. Pathol. |volume=35 |issue=6 |pages=574–584 |date=November 2016 |pmid=26974999 |doi=10.1097/PGP.0000000000000280 |url=}}</ref>
:*Melanoma or atypical moles: Epidemiological data have verified that melanoma or atypical moles increase the risk of developing vulvar cancer.
*Personal history of vulvar skin conditions
:*Smoking: Smoking can further increases the risk of developing vulvar cancer.  
**Women with a history of vulvar skin conditions have an increased risk of vulvar cancer. These conditions include [[lichen sclerosus]], which is a benign condition of the vulva that causes chronic [[inflammation]] of the skin. Having a vulvar skin condition can cause damage to the skin of the vulva over the long term. This damage may be what increases the risk for vulvar cancer.<ref name="pmid21057461">{{cite journal |vauthors=van de Nieuwenhof HP, Bulten J, Hollema H, Dommerholt RG, Massuger LF, van der Zee AG, de Hullu JA, van Kempen LC |title=Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma |journal=Mod. Pathol. |volume=24 |issue=2 |pages=297–305 |date=February 2011 |pmid=21057461 |doi=10.1038/modpathol.2010.192 |url=}}</ref>
:*Age: The risk of vulvar cancer goes up with age and the average age of women diagnosed with invasive vulvar cancer is 70.
*Personal history of [[Cervical cancer|cervical]], [[Vaginal Cancer|vaginal]] or [[anal cancer]]
**Women diagnosed with cancer of the [[cervix]], [[Vaginal|vagina]] or [[anus]] have a higher risk of developing vulvar cancer. This may be because these cancers have similar risk factors, such as [[HPV]] infection.
====Possible risk factors====
*Smoking
**Studies suggest that [[smoking]] increases a woman’s risk of developing vulvar cancer.
*Personal history of [[melanoma]]
**Studies suggest that women with a personal or family history of [[melanoma]] have a higher risk of developing melanoma of the vulva.
*Northern European ancestry


==References==
==References==
{{Reflist|2}}
{{Reflist|1}}
 
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Latest revision as of 16:57, 2 May 2019


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Overview

Common risk factors in the development of vulvar cancer are human papilloma virus (HPV), human immunodeficiency virus, vulvar intraepithelial neoplasia, and lichen sclerosus.

Risk factors

Known risk factors

  • Human immunodeficiency virus (HIV)
    • Scientists found that HIV can damage the body's immune system and make women more susceptible to persistent HPV infections.
  • Vulvar intraepithelial neoplasia (VIN)
    • Clinical data suggest that women with VIN have an increased risk of developing invasive vulvar cancer.[6]
  • Personal history of vulvar skin conditions
    • Women with a history of vulvar skin conditions have an increased risk of vulvar cancer. These conditions include lichen sclerosus, which is a benign condition of the vulva that causes chronic inflammation of the skin. Having a vulvar skin condition can cause damage to the skin of the vulva over the long term. This damage may be what increases the risk for vulvar cancer.[7]
  • Personal history of cervical, vaginal or anal cancer
    • Women diagnosed with cancer of the cervix, vagina or anus have a higher risk of developing vulvar cancer. This may be because these cancers have similar risk factors, such as HPV infection.

Possible risk factors

  • Smoking
    • Studies suggest that smoking increases a woman’s risk of developing vulvar cancer.
  • Personal history of melanoma
    • Studies suggest that women with a personal or family history of melanoma have a higher risk of developing melanoma of the vulva.
  • Northern European ancestry

References

  1. Risk factors for vulvar cancer. Canadian Cancer Society. http://www.cancer.ca/en/cancer-information/cancer-type/vulvar/risks/?region=ns Accessed on September 27, 2015
  2. de Koning MN, Quint WG, Pirog EC (March 2008). "Prevalence of mucosal and cutaneous human papillomaviruses in different histologic subtypes of vulvar carcinoma". Mod. Pathol. 21 (3): 334–44. doi:10.1038/modpathol.3801009. PMID 18192968.
  3. Halec G, Alemany L, Quiros B, Clavero O, Höfler D, Alejo M, Quint W, Pawlita M, Bosch FX, de Sanjose S (April 2017). "Biological relevance of human papillomaviruses in vulvar cancer". Mod. Pathol. 30 (4): 549–562. doi:10.1038/modpathol.2016.197. PMID 28059099.
  4. Weberpals JI, Lo B, Duciaume MM, Spaans JN, Clancy AA, Dimitroulakos J, Goss GD, Sekhon HS (August 2017). "Vulvar Squamous Cell Carcinoma (VSCC) as Two Diseases: HPV Status Identifies Distinct Mutational Profiles Including Oncogenic Fibroblast Growth Factor Receptor 3". Clin. Cancer Res. 23 (15): 4501–4510. doi:10.1158/1078-0432.CCR-16-3230. PMID 28377483.
  5. Brinton LA, Thistle JE, Liao LM, Trabert B (May 2017). "Epidemiology of vulvar neoplasia in the NIH-AARP Study". Gynecol. Oncol. 145 (2): 298–304. doi:10.1016/j.ygyno.2017.02.030. PMC 5629039. PMID 28236455.
  6. Bigby SM, Eva LJ, Fong KL, Jones RW (November 2016). "The Natural History of Vulvar Intraepithelial Neoplasia, Differentiated Type: Evidence for Progression and Diagnostic Challenges". Int. J. Gynecol. Pathol. 35 (6): 574–584. doi:10.1097/PGP.0000000000000280. PMID 26974999.
  7. van de Nieuwenhof HP, Bulten J, Hollema H, Dommerholt RG, Massuger LF, van der Zee AG, de Hullu JA, van Kempen LC (February 2011). "Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma". Mod. Pathol. 24 (2): 297–305. doi:10.1038/modpathol.2010.192. PMID 21057461.