Vulvar Cancer: Racial and Age Disparities Interview with:: Marcela G. del Carmen, M.D., M.P.H
Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology
Massachusetts General Hospital, 55 Fruit Street, Yawkey 9 E Boston, Massachusetts What are the main findings of the study?

Answer: The study sample included 7,973 women, including 7,363 (92.3%) whites and 610 (7.7%) AA, diagnosed with vulvar cancer from 1973 to 2009. African American women were younger and had a higher rate of distant metastasis compared to white women.  African American women were more likely to be treated by radiaton therapy and less likely to receive survival therapy. Although the study found that compared to white women, African Americans were more likely to be younger and have more advanced disease upon diagnosis, they had lower rates of vulvar cancer related mortality compared to white women. Where any of the findings unexpected?

Answer: Prior cross sectional and retrospective studies in the past had not demonstrated a racial difference in survival among women with vulvar cancer. What message should patients and providers take home from this study?

Answer: The study results highlights that vulvar cancer is not only a cancer affecting older women so that clinicians should consider vulvar biopsy and further evaluation of women with a persistent vulvar symptom or lesion, even if the patient is young. Given the existing data that HPV vaccination could prevent an estimated one half of vulvar cancer in young women, efforts should be make to include all populations at risk of HPV related disease, including vulvar cancer in vaccination programs. What future research do you recommend as a result of this report?

Answer: Future studies should focus on evaluating  trends in mortality over time and identifying differences in  vulvar cancer related mortality by HPV status.


Racial disparities and changes in clinical characteristics and survival for vulvar cancer over time

J. Alejandro Rauh-Hain, Joel Clemmer, Rachel M. Clark, Leslie S. Bradford, Whitfield B. Growdon, Annekathryn Goodman, David M. Boruta, John O. Schorge, Marcela G. Del Carmen

American Journal of Obstetrics & Gynecology – 26 July 2013 (10.1016/j.ajog.2013.07.021)  


Last Updated on August 1, 2013 by Marie Benz MD FAAD