Vulvar and vaginal cancers and dysplasia in France--an analysis of the hospital medical information system (PMSI) database.
OBJECTIVE
Literature on the epidemiology of vulvar and vaginal cancers is scarce. The incidence of these diseases seems to be increasing. It has been reported that about 40% of vulvar and 70% of vaginal cancers may be linked to human papillomavirus (HPV). This study aimed to assess the medical burden associated with hospitalizations and management of vulvar and vaginal cancers and dysplasia (VIN and VaIN) in France.


METHODS
A retrospective analysis using the French national hospital database (PMSI) was performed to assess the annual number of patients hospitalized for vulvar and vaginal cancers and VIN/VaIN, based on hospital admissions in 2006. Data for all stays and chemotherapy/radiotherapy sessions were extracted. SAE database (Statistiques annuelles des établissements de santé) was used to take into account patients who had radiotherapy sessions performed in the private sector which are not reported in the PMSI.


RESULTS
In 2006, 1237 and 623 patients were hospitalized for vulvar cancer and VIN, respectively. There were also 728 and 244 patients hospitalized for vaginal cancer and VaIN, respectively. Overall, about 35% of all patients were hospitalized in the private setting. For all lesions except vaginal cancer, surgery was the most common type of management. For vaginal cancer, medical care was the most prevalent (52%), followed by surgery (31%).


CONCLUSIONS
The burden of hospitalizations due to vulvar and vaginal cancers is substantial. Further research is needed to assess the outpatient burden due to these diseases especially for precancerous dysplasia which may be mostly managed in an outpatient setting.
Rémy
Vanessa
V
Sanofi Pasteur MSD, Health Economics Unit, 8 rue Jonas Salk, 69367 Lyon Cedex 07, France. vremy@spmsd.com
Mathevet
Patrice
P
Vainchtock
Alexandre
A
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D005260:Female; D005602:France / Q000453:epidemiology; D006751:Hospital Information Systems; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D012189:Retrospective Studies; D014621:Vagina / Q000473:pathology*; D014625:Vaginal Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy / Q000821:virology; D014844:Vulva / Q000473:pathology*; D014846:Vulvar Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy / Q000821:virology