Key clinical points

NICE cancer referral guidelines for vulval cancer suggest the following:


Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for vulval cancer in women with an unexplained vulval lump, ulceration or bleeding.

Introduction

Around 80% of vulval cancers are squamous cell carcinomas. Most cases occur in women over the age of 65 years. Vulval cancer is relatively rare with only around 1,200 cases diagnosed in the UK each year.

Epidemiology

  • Incidence: 2.20 cases per 100,000 person-years
  • Peak incidence: 70+ years
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Aetiology

Other than age, risk factors include:
  • Human papilloma virus (HPV) infection
  • Vulval intraepithelial neoplasia (VIN)
  • Immunosuppression
  • Lichen sclerosus

Clinical features

  • Lump or ulcer on the labia majora
  • May be associated with itching, irritation

Referral criteria

NICE cancer referral guidelines for vulval cancer suggest the following:


Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for vulval cancer in women with an unexplained vulval lump, ulceration or bleeding.