title: Trends in incidence and survival of Dutch women with vulvar squamous cell carcinoma.
abstract: OBJECTIVE
  Previous studies showed an increase in incidence of vulvar intraepithelial neoplasia (VIN), the premalignant lesion of Vulvar Squamous Cell Carcinoma (VSCC). Furthermore, during the last decades treatment of VSCC became less radical. Considering these changes the aim of this study was to describe trends of incidence and survival of patients with VSCC in the Netherlands.
  
  
  METHODS
  All patients with VSCC diagnosed between 1989 and 2010 (n=4614) were selected from the Netherlands Cancer Registry. Trends in age-adjusted incidence rates were evaluated by calculating the estimated annual percentage change (EAPC). Joinpoint regression analysis was used to detect changes in trends. Five-year relative survival rates were calculated for four time periods.
  
  
  RESULTS
  The incidence of VSCC has increased since 2002 (EAPC 5.0; 95% confidence interval (CI): 2.7-7.7%). In women aged <60years incidence rates increased significantly during the whole study period (EAPC 3.5%; 95% CI: 2.0-4.9), while in women aged ≥ 60 years only an increase has observed from 2004 onwards (EAPC 5.0; 95% CI: 1.5-8.6). Survival rates did not change over time.
  
  
  CONCLUSIONS
  The incidence rate of VSCC has increased from 2002 onwards in all women. Over the whole study period the increase was strongest in women aged <60 years. The introduction of less radical surgery did not affect survival.
authors.affiliation: Department of Research, Comprehensive Cancer Centre the Netherlands (IKNL), Utrecht, The Netherlands. Electronic address: m.schuurman@iknl.nl.
authors.forename: M S
authors.initials: MS
authors.lastname: Schuurman
authors.forename: L C G
authors.initials: LC
authors.lastname: van den Einden
authors.forename: L F A G
authors.initials: LF
authors.lastname: Massuger
authors.forename: L A
authors.initials: LA
authors.lastname: Kiemeney
authors.forename: M A
authors.initials: MA
authors.lastname: van der Aa
authors.forename: J A
authors.initials: JA
authors.lastname: de Hullu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D015999:Multivariate Analysis; D009426:Netherlands / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D016019:Survival Analysis; D014846:Vulvar Neoplasms / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult
keywords: Incidence; Survival; The Netherlands; Trends; Vulvar carcinoma