title: Clinically identifying women with vulvar lichen sclerosus at increased risk of squamous cell carcinoma: a case-control study.
abstract: OBJECTIVE
  To identify clinical factors that might identify women with vulvar lichen sclerosus who are at increased risk of developing squamous cell cacinoma.
  
  
  METHODS
  A retrospective, case-control study compared 46 women presenting between 1992 and 2000 with clinical and histologic evidence of squamous cell carcinoma of the vulva arising in a background of lichen sclerosus and 213 new referrals with vulvar lichen sclerosus during the same period.
  
  
  RESULTS
  The ages of the patients and presence of clinical hyperplasia were the only differences between the 2 groups.
  
  
  CONCLUSIONS
  Women presenting with vulvar cancer arising within a background of lichen sclerosus are significantly older than women presenting with lichen sclerosus. In addition, clinical evidence of squamous hyperplasia is independently associated with vulvar carcinoma. Neither the presence nor duration of symptoms nor the loss of vulvar architecture is a useful indicator of potential cancer risk.
authors.affiliation: Department of Gynecological Oncology, National Women's Hospital, Auckland, New Zealand. rwjones@xtra.co.nz
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Jones
authors.forename: Lynn
authors.initials: L
authors.lastname: Sadler
authors.forename: Steven
authors.initials: S
authors.lastname: Grant
authors.forename: Janet
authors.initials: J
authors.lastname: Whineray
authors.forename: Melissa
authors.initials: M
authors.lastname: Exeter
authors.forename: Darion
authors.initials: D
authors.lastname: Rowan
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D018459:Lichen Sclerosus et Atrophicus / Q000453:epidemiology / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011230:Precancerous Conditions / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D014846:Vulvar Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000601:surgery