Vaginal cancer epidemiology and demographics
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
In 2015, the incidence of vaginal cancer is approximately 2-3 per 100,000 individuals with a death number of 910.
Epidemiology and Demographics
- Carcinomas of the vagina are uncommon tumors comprising about 1% of the cancers that arise in the female genital system.
- Estimated new cases and deaths from vaginal (and other female genital) cancer in the United States in 2015:
- New cases: 4,070.
- Deaths: 910.
- Estimated new cases and deaths from vaginal (and other female genital) cancer in the United States in 2008:
- New cases: 2,210.
- Deaths: 760.
- Approximately 1 in 100,000 women will be diagnosed with in situ or invasive vaginal cancer (typically of squamous cell histology) [6,7]. The mean age at diagnosis of squamous cell carcinoma, the most common histologic type of vaginal cancer, is approximately 60 years, although the disease is seen occasionally in women in their 20s and 30s. Squamous carcinoma is more common as the age of the patient increases [6].
Most cases of vaginal cancer are likely mediated by human papillomavirus (HPV) infection, as with cervical cancer [8]. In a case-control study of 156 women with in situ or invasive vaginal cancer, over 50 percent were positive for antibodies to HPV subtypes 16 or 18 [9]. Thus, vaginal cancer has the same risk factors as cervical neoplasia: multiple lifetime sexual partners, early age at first intercourse, and being a current smoker [9,10].
There is evidence that some high-grade vulvar and vaginal intraepithelial neoplasia are monoclonal lesions derived from high-grade or malignant cervical disease [11]. This was supported by a retrospective cohort study of over 130,000 women in which women with cervical intraepithelial neoplasia 3 (CIN 3) had a significantly increased rate of developing vaginal cancer compared with all women within the same population and time period (standardized incidence ratio 6.8, 95% CI 5.6-8.2) [12]. A fourfold or greater increased risk was found until 25 years following CIN 3 diagnosis. Similarly, in a case series, 30 percent of all women with in situ or invasive vaginal disease had been treated for a prior anogenital tumor (primarily cervical), and 17 of 25 (70 percent) of invasive cancer biopsy specimens contained HPV 16/18 DNA. Similarly, in a series of 153 women with vaginal cancer treated at the Princess Margaret Hospital, 51 patients had a prior gynecologic malignancy; of these, 34 had cervical cancer [13]