-- Robert Preidt
THURSDAY, Oct. 20 (HealthDay News) -- The number of American
women with precancerous cells of the vulva increased more than
fourfold between 1973 and 2000, and the increase has led to the
release Thursday of new treatment guidelines by two major medical
Cancer of the vulva -- the outside of the genital area -- is
usually caused by infection with human papillomavirus (HPV), which
also causes cervical cancer. The precancerous condition -- known as
vulvar intraepithelial neoplasia (VIN) -- should be treated with
surgery, laser removal or medical therapy, according to the new
guidelines from the American College of Obstetricians and
Gynecologists and the American Society for Colposcopy and Cervical
VIN is divided into two main types. Usual-type VIN is often
associated with cancer-causing strains of HPV and risk factors such
as smoking and a weakened immune system. Differentiated VIN is
often linked to dermatologic conditions of the vulva.
In most cases of VIN, which is increasingly evident among women
in their 40s, there are visible raised lesions that may be white,
gray, red, brown or black.
"Most women with VIN will not notice any symptoms, but some may have bleeding, discharge, or itching," Dr. Gerald F. Joseph, Jr., ACOG's vice president for practice activities, said in a college news release.
"It would be sensible for women to periodically examine their vulvar area for any unusual spots or lesions, and if they find something, make an appointment with their ob-gyn," he advised.
While VIN appears to be increasing in the United States, the
risk of vulvar cancer is small when compared with cervical, ovarian
and uterine cancers, Dr. L. Stewart Massad, a member of ACOG's
Committee on Gynecologic Practice, said in the news release.
Much like precancerous cervical lesions, VIN is generally
slow-growing, he said. "The quadrivalent HPV vaccine that helps
prevent cervical cancer and genital warts has also been shown to
decrease the risk of VIN," Massad noted.
Visual examination is the only way to diagnose VIN, and most
lesions will need to be biopsied. If cancer is suspected, surgery
is the preferred treatment. Laser removal is an acceptable
treatment for VIN lesions that appear precancerous. Low-grade
lesions can be monitored or treated with a topical cream (5 percent
imiquimod) for 12 to 20 weeks, according to the guidelines.
The recurrence rate of VIN is high regardless of the treatment
method, and women who've had VIN remain at risk for recurrent VIN
and vulvar cancer for the remainder of their lives.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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