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Relationship between vulvar symptoms and incidence of vulvar cancer in women referred to a rapid access clinic

Lookup NU author(s): Andrew Bryant

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Abstract

© 2019 International Federation of Gynecology and Obstetrics Objective: We performed a study to estimate incidence of vulvar cancer in women with vulvar symptoms (irritation, pain, bleeding +/− presence of lesion) referred to a secondary care, rapid-access clinic. Methods: Prospective data collection of all direct referrals from a primary to a secondary care gynecological oncology clinic from 2011 to 2016, for women with suspicious vulvar symptoms. Results: 32/393 (8.1%) women had vulvar cancer, and 24/393 (6.1%) had a premalignant lesion. Multivariate logistic regression showed that women referred without a specific lesion had considerably lower odds of a diagnosis of vulvar cancer than those with a lesion (OR=0.11, 95% CI: 0.03–0.49). In total, 30/234 (12.8%) women with a vulvar lesion (mass or ulcer), had vulvar cancer, compared with 2/159 (1.3%) of those referred without a lesion (these patients had vulvar irritation and bleeding but had a visible lesion on examination). None of the 140 women with irritation alone, in the absence of a visible lesion or bleeding, had pre-invasive disease or cancer. Conclusion: Presence of a vulvar lesion, especially if painful/bleeding, has a high positive predictive value for vulvar cancer and 12.8% of women presenting with any vulvar lesion to secondary care had cancer.


Publication metadata

Author(s): Wiggans A, Coleridge S, Bryant A, Morrison J

Publication type: Article

Publication status: Published

Journal: International Journal of Gynecology and Obstetrics

Year: 2019

Pages: Epub ahead of print

Online publication date: 01/04/2019

Acceptance date: 29/03/2019

ISSN (print): 0020-7292

ISSN (electronic): 1879-3479

Publisher: John Wiley and Sons Ltd

URL: https://doi.org/10.1002/ijgo.12818

DOI: 10.1002/ijgo.12818

PubMed id: 30932169


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