An accurate histological diagnosis of GCT is essential. Stage IV disease is an extreme rarity. However, tumor stage overcomes other possible clinical prognostic factors for GCT-specific survival. Fertility-sparing surgery, the use of oral contraceptives, or hormonal replacement therapy seems not to be risk factors for survival.

Malignant potential of lichen sclerosus (LS) has been suspected, but evidence is sparse. We used the population-based Finnish Cancer Registry data to further study this connection. We identified all women with the diagnosis of LS (n = 7,616) listed in the Finnish Hospital Discharge Registry from 1970 to 2012. The cohort was followed through the Finnish Cancer Registry for subsequent cancer diagnoses until 2014. Standardized incidence ratios (SIRs) were calculated for different cancers by dividing the observed numbers of cancers by expected ones. The expected numbers were based on national cancer incidence rates. During the follow-up period, we found 812 cancers among patients with LS (SIR: 1.13, 95% CI 1.05-1.21). LS was associated with an increased risk of vulvar (182 cases, SIR: 33.6, 95% CI 28.9-38.6) and vaginal cancer (4 cases, SIR: 3.69, 95% CI 1.01-9.44). The risk of cancers of the uterine cervix and lung was significantly decreased. LS is associated with an increased risk for vulvar and vaginal cancer. These data are important when designing the care of women diagnosed with LS.

Primary fallopian tube carcinoma is very rare. In Western countries, it accounts for about 1% of all female genital malignant tumors. Its etiology remains poorly known, but high parity is considered to be protective. We studied determinants of incidence of primary fallopian tube carcinoma in Finland. Incidence rates for primary fallopian tube carcinoma, according to the population based Finnish Cancer Registry, from 1953-97 were assessed by age, year of diagnosis, and type of residential area. Standardized incidence ratios (SIRs) for the years 1971-95 were calculated by occupation and social class variables taken from the 1970 Population Census. There were 485 cases of primary fallopian tube carcinoma registered during 45 years. The age-adjusted incidence rate increased from 1.2/1,000,000 in 1953-57 to 5.4/ 1,000,000 in 1993-97. This 4.5-fold increase in incidence rate corresponds to a 7-fold increase in the number of new cases. The increase is attributable to the age group beyond 55 years, the peak incidence occurring between 60 -64 years. Although the relative increase in incidence rate has been larger in rural areas than in cities, the rate in the latter remains 2-fold. Women in the 2 highest social classes had a 1.8-fold incidence (95% CI ‫؍‬ 1.2-2.6) as compared to the lowest social class. Women in agriculture and those not working outside the home had only half the cancer incidence of those in academic or clerical occupations. The incidence of primary fallopian tube carcinoma increases in Finland. Evidently, the incidence has increased simultaneously with the affluence of urban life. Part of the variation in incidence correlates with variation in parity. © 2003 Wiley-Liss, Inc. Key words: primary fallopian tube carcinoma; incidence; social class; occupationPrimary fallopian tube carcinoma (PFTC) is a very rare but highly aggressive disease, reported to comprise 0.1-1.1% of all female genital malignancies. 1 PFTC was described for the first time by Renaud in 1847. 2 Although its etiologic factors are largely unknown, they have been considered to be similar to those of ovarian carcinoma. Histologically, most PFTCs are pure adenocarcinomas, the main type being serous adenocarcinoma. Occasional cases of endometrioid, clear cell, transitional cell, and glassy cell carcinomas have been reported. 3 Finland is an industrialized country with 5.2 million inhabitants. Most Finns live in urban communities. Finland is characterized by a relatively homogenous population and an effective nearly freeof-charge healthcare system. The nationwide population-based cancer registry allowed us to study incidence characteristics of PFTC over a period of 45 years in Finland. MATERIAL AND METHODSMore than 99% of all cancer cases have been reported to the Finnish Cancer Registry 1953. 4 In the 1990s, about 95% of the cases were microscopically confirmed, and about 1% of the cases based on death certificate only. 5 The Registry obtains information from hospitals and other institutions with inpatient beds, general practitioners, and pa...