Vulval cancer: prevention and screening.
The incidence of vulval cancer is rising, both in older women and those under 50 years of age. Vulval cancer has at least two types, one arising in association with lichen sclerosus (LS) and the other with vulval intraepithelial neoplasia (VIN). Recent pathological and aetiological descriptions are included, along with the latest description of VIN terminology. Prevention of and screening for vulval cancer will require greater understanding of why some women with LS and VIN are at greater risk: recent studies of molecular change might contribute to this. The use of vulval cytology and toluidine blue staining is described. Patient or vulval awareness may help but clinical features are non-specific. Prophylactic vaccination against HPV and campaigns against smoking may contribute in the future.
Maclean
Allan B
AB
Department of Obstetrics and Gynaecology, Royal Free Campus, Royal Free and University College, Rowland Hill Street, Hampstead, London NW3 2PF, UK. amaclean@medsch.ucl.ac.uk
D002278:Carcinoma in Situ / Q000145:classification; D018450:Disease Progression; D005260:Female; D006801:Humans; D008010:Lichen Planus / Q000473:pathology; D008403:Mass Screening / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods; D011230:Precancerous Conditions / Q000473:pathology; D009626:Terminology as Topic; D007724:Vulvar Lichen Sclerosus / Q000473:pathology; D014846:Vulvar Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000517:prevention & control*