title: Vulvar carcinoma in Norway: A 50-year perspective on trends in incidence, treatment and survival.
abstract: To explore trends in vulvar squamous cell carcinoma (SCC) incidence, age and stage at diagnosis, treatment and survival in Norway from 1961 to 2010.
  
  
  
  From 1961 to 2010, 2233 cases of vulvar SCC were extracted from the Cancer Registry of Norway. Data on age at diagnosis, tumor morphology, stage of the disease and treatment were analyzed. Age-standardized incidence rates, adjusted to the Norwegian standard population, were computed. Relative survival was calculated as a ratio of the observed survival in the study population over the expected survival in the background population. Multivariate Cox model was fitted to estimate hazard ratios.
  
  
  
  The overall incidence of vulvar SCC increased >2.5 fold (from 1.70 to 4.66 per 100,000 women/year; P<0.01). Age-specific incidence rates increased among women aged ≤60years (by 150% in age group 0-39years, 175% in age group 40-49years and 68% in age group 50-59years). From 1971 to 2010, the percentage of patients receiving surgery as only treatment decreased from 81% to 61%, whereas the use of radiation and combination therapy (surgery and radiation) increased from 3% to 11% and 6% to 20%, respectively. 5-year relative survival increased significantly among women ≤80years (from 72% to 83% among women aged ≤60years and from 60% to 65% among women aged 61-80years).
  
  
  
  The incidence of vulvar SCC has increased since the sixties, particularly among women younger than 60years. Despite less aggressive surgical treatment, survival has improved.
authors.affiliation: Department of Obstetrics and Gynecology, Sorlandet Hospital HF, P.O. Box 416, 4604 Kristiansand, Norway. Electronic address: christin.julia.meltzer-gunnes@sshf.no.
authors.forename: Christin Julia
authors.initials: CJ
authors.lastname: Meltzer-Gunnes
authors.affiliation: Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway. Electronic address: Milada-Cvancarova.smastuen@hioa.no.
authors.forename: Milada Cvancarova
authors.initials: MC
authors.lastname: Småstuen
authors.affiliation: Department of Gynecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424 Oslo, Norway. Electronic address: gbk@ous-hf.no.
authors.forename: Gunnar Balle
authors.initials: GB
authors.lastname: Kristensen
authors.affiliation: Department of Gynecological Oncology, The Norwegian Radium Hospital, Oslo University Hospital, P.O. Box 4953 Nydalen, 0424 Oslo, Norway. Electronic address: c.g.trope@medisin.uio.no.
authors.forename: Claes Göran
authors.initials: CG
authors.lastname: Tropé
authors.affiliation: Center for Laboratory Medicine, Ostfold Hospital HF, P.O. Box 300, 1714 Gralum, Norway. Electronic address: Agnes.Kathrine.Lie@so-hf.no.
authors.forename: Agnes Kathrine
authors.initials: AK
authors.lastname: Lie
authors.affiliation: Department of Obstetrics and Gynecology, Sorlandet Hospital HF, P.O. Box 416, 4604 Kristiansand, Norway. Electronic address: ingvild.vistad@sshf.no.
authors.forename: Ingvild
authors.initials: I
authors.lastname: Vistad
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016016:Proportional Hazards Models; D012042:Registries; D014846:Vulvar Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D055815:Young Adult
keywords: Incidence; Squamous cell carcinoma; Survival; Vulvar cancer