CARCINOMA OF THE VULVA IN YOUNG-WOMEN

Objective: To determine if young women with carcinoma of the vulva hav e a different risk factor history and outcome compared with older wome n. Methods: We conducted a retrospective review of the medical records of 78 women treated at the Medical College of Georgia for squamous ca rcinoma of the vulva during 1979-1993. Women younger than 45 years wer e compared with those 45 and over for historic risk factors, treatment modality, and outcome. Results: Over the study interval, the average presenting age of these patients decreased from 69 to 55 years. Women under 45 were found to have a stronger history of condyloma (P < .001, 95% confidence interval [CI] 3.69-87.96). There was no significant di fference by age in the duration of symptoms before presentation, smoki ng history, or tumor size. Women 45 and over were more likely to have advanced-stage disease (International Federation of Gynecology and Obs tetrics [FIGO] stage III or IV) (P = .03, 95% CI 0.43-0.91). Treatment did not differ significantly with age. In a univariate analysis, adva nced FIGO stage, presence of metastases, and tumor size were associate d with shorter survival. There was no detected difference in survival for women in either age group. Conclusion: There appears to be a trend in our patient population toward younger women presenting with squamo us carcinoma of the vulva. Human papillomavirus infection appears to b e more common in younger women with vulvar carcinoma. There may be a d ifference in the etiologies producing squamous carcinomas of the vulva . Education encouraging- the early detection and prevention of sexuall y transmitted diseases might alter the rising incidence of this diseas e in younger women.