Vulvar cancer

Vulvar cancer
Drawing of vulvar cancer
Specialty	Gynecology
Symptoms	Lump, itchiness, changes in the skin, or bleeding of the vulva[1]
Usual onset	After the age of 45[2]
Types	Squamous cell cancer, adenocarcinoma, melanoma, sarcoma, basal cell carcinoma.[3]
Risk factors	Vulvar intraepithelial neoplasia (VIN), HPV infection, genital warts, smoking, many sexual partners[1][3]
Diagnostic method	Physical examination, tissue biopsy[1]
Differential diagnosis	Lichen sclerosus, hyperplasia[4]
Prevention	HPV vaccination[5]
Treatment	Surgery, radiation therapy, chemotherapy, biologic therapy[1]
Prognosis	Five-year survival ~ 71% (US 2015)[2]
Frequency	44,200 (2018)[6]
Deaths	15,200 (2018)[6]

Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals.^[1] It most commonly affects the labia majora.^[1] Less often, the labia minora, clitoris, or Bartholin's glands are affected.^[1] Symptoms include a lump, itchiness, changes in the skin, or bleeding from the vulva.^[1]

Risk factors include vulvar intraepithelial neoplasia (VIN), HPV infection, genital warts, smoking, and many sexual partners.^[1][3] Most vulvar cancers are squamous cell cancers.^[4] Other types include adenocarcinoma, melanoma, sarcoma, and basal cell carcinoma.^[3] Diagnosis is suspected based on physical examination and confirmed by tissue biopsy.^[1] Routine screening is not recommended.^[3]

Prevention may include HPV vaccination.^[5] Standard treatments may include surgery, radiation therapy, chemotherapy, and biologic therapy.^[1] Vulvar cancer newly affected about 44,200 people and resulted in 15,200 deaths globally in 2018.^[6] In the United States, it newly occurred in about 6,070 people with 1,280 deaths a year.^[2] Onset is typically after the age of 45.^[2] The five-year survival rate for vulvar cancer is around 71% as of 2015.^[2] Outcomes, however, are affected by whether spread has occurred to lymph nodes.^[4]