Levi F, Randimbison L, La Vecchia C
Institut universitaire de médecine sociale et préventive, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Ann Oncol. 1998 Nov;9(11):1229-32. doi: 10.1023/a:1008433817832.
To analyse trends in incidence, survival and risk of second neoplasms following vaginal and vulvar cancers using data collected by the Swiss Cancer Registry of Vaud over the 21-year period 1974-1994.
Subjects were 257 vulvo-vaginal cancers. Of these, 69 were vaginal, 153 vulvar cancers, and 35 non-specified lower genital tract neoplasms; 94 in situ neoplasms were also registered (85 for the vulva).
Invasive vaginal cancer incidence decreased from 0.8 in 1974-1984 to 0.4/100,000 women in 1985-1994, while invasive vulvar cancer incidence remained approximately stable around 1.2/100,000 (world standard); incidence of in situ vulvar cancer increased from 0.8 to 1.3/100,000, the rise being larger in younger women. Significant excesses for second primary neoplasms were observed for pro-pharyngeal and lung cancer, and for non-melanomatous skin neoplasms, as well as for invasive vulvar cancers following in situ cancers.
This population-based dataset confirms that the incidence of in situ vulvar (but not invasive vulvar or vaginal cancer) has been increasing over the last 20 years. The excess second primary neoplasms supports the hypotheses that human papillomavirus and cigarette smoking are related to vulvo-vaginal neoplasms.
利用沃州瑞士癌症登记处1974年至1994年21年间收集的数据，分析阴道癌和外阴癌后第二肿瘤的发病率、生存率及风险趋势。
研究对象为257例外阴阴道癌。其中，阴道癌69例，外阴癌153例，下生殖道未明确肿瘤35例；还登记了94例原位肿瘤（外阴85例）。
浸润性阴道癌发病率从1974 - 1984年的0.8/10万女性降至1985 - 1994年的0.4/10万女性，而浸润性外阴癌发病率在1.2/10万（世界标准）左右基本保持稳定；原位外阴癌发病率从0.8/10万升至1.3/10万，年轻女性上升幅度更大。观察到第二原发性肿瘤在咽癌、肺癌、非黑素瘤皮肤肿瘤以及原位癌后的浸润性外阴癌中显著增多。
基于人群的该数据集证实，过去20年原位外阴癌（而非浸润性外阴癌或阴道癌）的发病率一直在上升。第二原发性肿瘤增多支持了人乳头瘤病毒和吸烟与外阴阴道肿瘤相关的假说。
