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At least 50% of in-situ vulvar ca seen in women 20-39 years old. (May be Related to HPV Infection).
HOUSTON -- The incidence of in-situ carcinoma of the vulva is increasing, and it's affecting women at younger ages, Dr. Raymond H. Kaufman said at a conference on vulvovaginal diseases sponsored by Baylor College of Medicine.
Most current series show at least 50% of cases occurring in women 20-39 years old, while 30-40 years ago, most of the patients were post menopausal.
These findings are probably related to the rising prevalence of human papillomavirus (HPV) infection.
Younger women are most likely to have the poorly differentiated warty or basilar type of vulvar intraepithelial neoplasia (VIN) III in which associated HPV DNA is frequently found, said Dr. Kaufman, professor of obstetrics and gynecology and pathology at Baylor College of Medicine.
Older patients often have a well-differentiated form of VIN III that rarely shows HPV DNA, and they often have lichen sclerosus in the adjacent tissue. Since both types of VIN III have been associated with an increased risk of invasive vulvar carcinoma, some investigators have suggested that the cancer may develop through two different pathways.
Pruritus is the most common symptom of VIN III, occurring in about 38% of patients. Another 14%-15% of patients present with a mass, which is usually condylomata.
Nearly half of all patients with VIN III are asymptomatic, however, and the disease is discovered ...
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