Vulvar Cancer: Overview

What is vulvar cancer?

It is an abnormal growth of malignant cells (neoplasm, tumor) in the vulva. The vulva is defined as the female external genitalia, and includes the labia majora, labia minora, clitoris, and vestibule, or entryway, of the vagina.

About 70% of vulvar cancers involve the labia, (mainly the labia majora), 15% - 20% involve the clitoris, and another 15% - 20% involve the perineum, which is the area of sensitive skin located between the vagina and the anus. In about 5% of cases, the cancer is present at more than one site.

What are the different types of vulvar cancer?

The vulva is essentially epithelial skin, and so the main tumor types that affect this area are skin-related cancers.

The majority of vulvar cancers are squamous cell carcinomas, which typically develop at the edges of the labia majora/ minora or the vagina. As with vaginal squamous cell carcinomas, vulvar squamous cell cancers are slow-growing and usually develop from "precancerous", pre-invasive areas called vulvar intraepithelial neoplasia (VIN).

Melanoma is the second most common type and represents about 5% - 10% of vulvar cases; roughly half involve the labia majora.

The most common skin-cancer in sun-exposed areas is basal cell carcinoma, and as expected, this type rarely occurs on the vulva.

Adenocarcinomas of the vulva are also rare, but can develop from glands such as the Bartholin's glands at the vaginal opening.

How common is vulvar cancer?

Vulvar cancer is a relatively rare diagnosis, representing about 5% of all gynecologic cancers, and only about 1% of all female cancers in general. There are about 3,500 new cases reported annually in the US and approximately 900 death a year attributed to this disease. The incidence of vulvar cancers has remained stable over the past two decades but the rates of precancerous lesions has more than doubled over the same period of time. The cause for the growing number of cases is not well-understood.

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