title: Incidence patterns and temporal trends of invasive nonmelanotic vulvar tumors in Germany 1999-2011. A population-based cancer registry analysis.
abstract: OBJECTIVE
  Time trends on the incidence and characteristics of invasive vulvar cancer in Germany have so far been studied in few local population- and hospital based tumor registries. We aimed to provide an overview on recent developments of vulvar cancer in Germany, using population-based cancer registry data.
  
  
  METHODS
  We analyzed the data on vulvar cancer of eight population-based German cancer registries for the period 1999-2011. ICD-10 codes and ICD-O-3 morphology codes were used to select site and histologic types. The annual percentage change was calculated on age-adjusted incidence rates with a joinpoint regression model.
  
  
  RESULTS
  A total of 12,711 registered cases of invasive carcinoma of the vulva were included in the analyses, hereof were 12,205 of squamous cell origin. Age-standardized incidence rates of vulvar cancer annually increased by 6.7% (95% confidence limits: 5.6-7.9) from 1.7 per 100,000 women in 1999 to 3.6 per 100,000 women in 2011. An increase was observed among women of all ages, and especially between 30 and 69 years of age.
  
  
  CONCLUSIONS
  The annual incidence of invasive carcinoma of the vulva nearly doubled in the past decade in Germany, considerably exceeding the rates observed in other Western European countries. A combination of changes in risk factors, and documentation practice might have contributed to the observed substantial increase in vulvar cancer incidence.
authors.affiliation: Robert Koch-Institute, Department of Epidemiology and Health Monitoring, German Centre for Cancer Registry Data, Berlin, Germany; Cancer Epidemiology, University Cancer Centre Dresden, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Buttmann-Schweiger
authors.affiliation: Cancer Epidemiology, University Cancer Centre Dresden, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Stefanie J
authors.initials: SJ
authors.lastname: Klug
authors.affiliation: Department of Gynaecology and Obstetrics, Klinikum Wolfsburg, Wolfsburg, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Luyten
authors.affiliation: Saarland Cancer Registry, Saarbrücken, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Holleczek
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Heitz
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Kliniken Essen Mitte, Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: du Bois
authors.affiliation: Robert Koch-Institute, Department of Epidemiology and Health Monitoring, German Centre for Cancer Registry Data, Berlin, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kraywinkel
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012042:Registries; D012189:Retrospective Studies; D014846:Vulvar Neoplasms / Q000453:epidemiology* / Q000473:pathology