{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:57:13Z","timestamp":1780095433415,"version":"3.54.0"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T00:00:00Z","timestamp":1382400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the trends and age characteristics of vulval cancer incidence, mortality, survival and stage of disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective population\u2010based observational study based on cancer registry and Office for National Statistics data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All women diagnosed with vulval cancer, defined by the site of the tumour (<jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u201010 code <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Including all <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>51 cases, Poisson regression was used to test for trends in incidence and mortality rates, and generalised linear modelling was used to test for trends in relative survival. Excluding women with melanomas, basal cell carcinomas and Paget disease, stage was investigated as a percentage of staged data by age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Age\u2010standardised incidence and mortality rates, relative survival rates and stage of disease at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1990, there was a statistically significant increase in overall incidence (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.018) and decrease in mortality (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). In addition, there were statistically significant increases in overall survival (1\u2010year, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001; 5\u2010year, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). However, from 1990, incidence increased in women aged 20\u201339\u00a0years (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002), 40\u201349 and 50\u201359\u00a0years (both <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and 60\u201369\u00a0years (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.030) and decreased in women aged 80\u00a0years and above (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). There were statistically significant decreases in mortality in women aged \u226560\u00a0years (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), and statistically significant increases in 1\u2010year survival in women aged \u226540\u00a0years (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.047) and in 5\u2010year survival in women aged 40\u201349 and \u226560\u00a0years (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.011). Stage patterns by age highlight diagnosis at an earlier stage in younger women and more advanced stage diagnosis in older women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Survival from vulval cancer has improved and mortality has decreased since 1990. The overall incidence of disease has increased as a result of more new diagnoses in the under 70\u2010year age group.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12459","type":"journal-article","created":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T16:09:07Z","timestamp":1382458147000},"page":"728-738","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Vulval cancer incidence, mortality and survival in England: age\u2010related trends"],"prefix":"10.1111","volume":"121","author":[{"given":"J","family":"Lai","sequence":"first","affiliation":[{"name":"Public Health England (PHE) Knowledge and Intelligence Team (East Midlands) (formerly Trent Cancer Registry) Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Elleray","sequence":"additional","affiliation":[{"name":"Public Health England (PHE) Knowledge and Intelligence Team (East Midlands) (formerly Trent Cancer Registry) Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Nordin","sequence":"additional","affiliation":[{"name":"East Kent Hospitals University NHS Foundation Trust Margate UK"},{"name":"Gynaecological Site Specific Clinical Reference Group (SSCRG) National Cancer Intelligence Network (NCIN) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Hirschowitz","sequence":"additional","affiliation":[{"name":"Gynaecological Site Specific Clinical Reference Group (SSCRG) National Cancer Intelligence Network (NCIN) London UK"},{"name":"Birmingham Women's NHS Trust Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Rous","sequence":"additional","affiliation":[{"name":"National Cancer Registration Service (Eastern) (formerly Eastern Cancer Registry and Information Centre, ECRIC) Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Gildea","sequence":"additional","affiliation":[{"name":"Public Health England (PHE) Knowledge and Intelligence Team (East Midlands) (formerly Trent Cancer Registry) Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Poole","sequence":"additional","affiliation":[{"name":"Public Health England (PHE) Knowledge and Intelligence Team (East Midlands) (formerly Trent Cancer Registry) Sheffield UK"},{"name":"Gynaecological Site Specific Clinical Reference Group (SSCRG) National Cancer Intelligence Network (NCIN) London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,22]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Human Papillomavirus and Related Cancers in United Kingdom, Summary Report 2010","author":"World Health Organization (WHO)","year":"2010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2005.10.007"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2006.05.111"},{"key":"e_1_2_7_5_1","volume-title":"Cancer Statistics Registrations, England (Series MB1) No. 41","author":"Office for National Statistics (ONS)","year":"2010"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1048-891X.2004.14524.x"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2012.06.027"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.12.006"},{"key":"e_1_2_7_9_1","first-page":"5045","article-title":"Quality of life and sexuality of patients after treatment for gynaecological malignancies: results of a prospective study in 55 patients","volume":"32","author":"Pilger A","year":"2012","journal-title":"Anticancer Res"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAT.0b013e328357a001"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604871"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-008-0677-5"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-009-9418-8"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-1850-9"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.01.041"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19970415)16:7<791::AID-SIM500>3.0.CO;2-#"},{"key":"e_1_2_7_17_1","first-page":"159","article-title":"Analysis of survival. 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