title: A cluster of vulvar cancer and vulvar intraepithelial neoplasia in young Australian indigenous women.
abstract: OBJECTIVE
  To describe the epidemiological features of a possible disease cluster of vulvar cancer and pre-cancers in Australian Indigenous women living in the Northern Territory (NT) of Australia.
  
  
  METHODS
  We identified NT-resident women with a confirmed histological diagnosis of vulvar cancer or high-grade vulvar intraepithelial neoplasia (VIN) between 1 January 1996 and 31 December 2005.
  
  
  RESULTS
  Seventy-one women were identified; 32 diagnosed with vulvar cancer and 39 with high-grade VIN. Most women diagnosed were Indigenous, aged less than 50 years and living in remote communities in the East Arnhem (EA) district, on the north-east coast of the NT. The age-adjusted incidence rate of vulvar cancer in EA Indigenous women aged 0-49 years was 31.1 per 100,000 (95% CI 13.1-49.1), over 50 times higher than the national Australian rate (0.4 per 100,000, 95% CI 0.4-0.5) for the same age-group. In the age-group of 0-49 years, the age-adjusted incidence rate of VIN for EA Indigenous women was 34.7 per 100,000 (95% CI 15.2-54.3), compared with 6.7 per 100,000 (95% CI 2.0-11.4) for Indigenous women living elsewhere in the Top End of the NT.
  
  
  CONCLUSIONS
  These data provide evidence of a geographic cluster of vulvar cancer in remote Indigenous communities in northern Australia.
authors.affiliation: Services, Systems and Society Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT, 0811, Australia.
authors.forename: John R
authors.initials: JR
authors.lastname: Condon
authors.forename: Alice R
authors.initials: AR
authors.lastname: Rumbold
authors.forename: Jane C
authors.initials: JC
authors.lastname: Thorn
authors.forename: Margaret M
authors.initials: MM
authors.lastname: O'Brien
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Davy
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Zardawi