title: Vulvar and Vaginal Cancer, Vulvar Intraepithelial Neoplasia 3 and Vaginal Intraepithelial Neoplasia 3: Experience of a Referral Institute.
abstract: BACKGROUND
  Vulvar and vaginal malignant and premalignant lesions are uncommon and are clinically heterogeneous diseases with two pathways of carcinogenesis: human papillomavirus (HPV) induced or non-HPV induced.
  
  
  OBJECTIVE
  To evaluate the demographic and clinical characteristics associated with vulvar or vaginal cancer and vulvar and vaginal intraepithelial neoplasia 3 (VIN3, VAIN3).
  
  
  METHODS
  We conducted a retrospective chart review of 148 women with vulvar and vaginal malignancy and pre-malignancy for the period October 2004 to October 2012, and identified 59 and 19 patients with vulvar and vaginal cancer respectively, and 57 and 13 patients with VIN3 and VAIN3 respectively
  
  
  RESULTS
  The median age of vulvar cancer patients was 30 years older than that of VIN3 patients. HPV was found in 60% and 66.6% of vulvar and vaginal cancer patients respectively, and in 82.3% and 84.6% of patients with VIN3 and VAIN3 respectively. A history of cervical intraepithelial neoplasia (CIN) or warts was observed in 10% and 10.5% of vulvar and vaginal cancer patients respectively, and in 57.9% and 46% of patients with VIN3 and VAIN3 respectively. In 52.6% of patients the vaginal cancer was metastases from other organs.
  
  
  CONCLUSIONS
  Most women with vulvar carcinoma are older than 70 years. VIN3 and VAIN3 are associated with HPV infection and the most prevalent type is HPV16. Almost half the vaginal cancers are associated with metastases from other organs and almost half of VAIN3 is associated with past cervical dysplasia or carcinoma.
authors.forename: Efraim
authors.initials: E
authors.lastname: Siegler
authors.forename: Yakir
authors.initials: Y
authors.lastname: Segev
authors.forename: Lena
authors.initials: L
authors.lastname: Mackuli
authors.forename: Ron
authors.initials: R
authors.lastname: Auslender
authors.forename: Mayan
authors.initials: M
authors.lastname: Shiner
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
mesh_terms: D000367:Age Factors; D000368:Aged; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000473:pathology; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000302:isolation & purification; D012189:Retrospective Studies; D012307:Risk Factors; D014625:Vaginal Neoplasms / Q000208:ethnology / Q000473:pathology; D014846:Vulvar Neoplasms / Q000208:ethnology / Q000473:pathology; D014860:Warts / Q000453:epidemiology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology