Trends in vulvar neoplasia - Increasing incidence of vulvar intraepithelial neoplasia and squamous cell carcinoma of the vulva in young women

OBJECTIVE: To determine trends in the epidemiology of vulvar intraepithelia l neoplasia (VIN) and squamous cell carcinoma (SCC) of the vulva in a Centr al European sample during the last decade. STUDY DESIGN: A total of 366 women with VIN 2 and 3 (n=128) or vulvar SCC ( n=238) presented within two four-year periods separated by one decade (1985 -1988 and 1994-1997). We performed a retrospective analysis of the clinicop athologic records of the cohorts. RESULTS: The number of women with high grade VIN (n=29 vs. 99) tripled duri ng the last decade, while the incidence of vulvar SCC remained stable. In w omen less than or equal to 50 years old, the incidence of high grade VIN in creased by 392% (n=12 vs. 59) and of invasive vulvar cancer by 157% (n=7 vs . 18). In the earlier cohort there were 7/126 (5%) women with invasive vulv ar SCC under the age of 50 and, in the latter cohort, 18/112 (16%, P < .01) . CONCLUSION: Over the past decade a striking increase occurred in the incide nce of VIN and an increase in invasive vulvar SCC in young women.