Analyzing Prior Clinical Events at Presentation in 102 Women With Vulvar Carcinoma: Evidence of Diagnostic Delays

Jones, Ronald W.; Joura, Elmar A.

doi:10.1097/00006254-200002000-00017

Cited by 8 publications

(12 citation statements)

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“…There was no conclusive evidence in relation to the influence of age on presentation with symptoms of upper gastrointestinal (Macdonald et al , 2006) or gynaecological cancers (Fruchter et al , 1980; Franceschi et al , 1983; Fowler et al , 1984; Smith and Anderson, 1985; Dhamija et al , 1993; Andersen et al , 1995; Coates et al , 1996; Risberg et al , 1996; Jones and Joura, 1999; Goff et al , 2000) (Tables 1 and 3, 4 and 5).…”

Section: Resultsmentioning

confidence: 99%

Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers

et al. 2009

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Background:It has been suggested that the known poorer survival from cancer in the United Kingdom, compared with other European countries, can be attributed to more advanced cancer stage at presentation. There is, therefore, a need to understand the diagnostic process, and to ascertain the risk factors for increased time to presentation.Methods:We report the results from two worldwide systematic reviews of the literature on patient-mediated and practitioner-mediated delays, identifying the factors that may influence these.Results:Across cancer sites, non-recognition of symptom seriousness is the main patient-mediated factor resulting in increased time to presentation. There is strong evidence of an association between older age and patient delay for breast cancer, between lower socio-economic status and delay for upper gastrointestinal and urological cancers and between lower education level and delay for breast and colorectal cancers. Fear of cancer is a contributor to delayed presentation, while sanctioning of help seeking by others can be a powerful mediator of reduced time to presentation. For practitioner delay, ‘misdiagnosis' occurring either through treating patients symptomatically or relating symptoms to a health problem other than cancer, was an important theme across cancer sites. For some cancers, this could also be linked to inadequate patient examination, use of inappropriate tests or failing to follow-up negative or inconclusive test results.Conclusion:Having sought help for potential cancer symptoms, it is therefore important that practitioners recognise these symptoms, and examine, investigate and refer appropriately.

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Section: Resultsmentioning

confidence: 99%

Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers

et al. 2009

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“…Prior studies show delays from 6 months to 5 years between first reported symptoms and diagnosis. 2 Our findings highlight the need for providers to maintain a low threshold for biopsy to rule out malignant disease in any long-standing vulvar lesion or “rash.”…”

Section: To the Editormentioning

confidence: 73%

“…2,3 Most patients in our study (74%) were aware of vulvar symptoms (itching, bleeding, discharge), lesions, or both. Documented exam descriptors used for the vulvar cancers included “exophytic,” “plaque,” “fungating,” “white,” “raised,” “thickened,” and “erythematous.” With these variable presentations, vulvar cancer can mimic conditions including lichen sclerosus, contact dermatitis, warts, and other inflammatory or benign neoplastic conditions.…”

Section: To the Editormentioning

confidence: 78%

The diagnostic challenge of vulvar squamous cell carcinoma: Clinical manifestations and unusual human papillomavirus types

Sagdeo

Gormley

Abuabara

et al. 2014

Journal of the American Academy of Dermatology

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“…There is also evidence to suggest that delay in diagnosis could be from failures or procrastination in performance of biopsies of abnormal appearing vulvar skin [3]. One study reported that 31% of women had three or more medical consultations for vulvar symptoms prior to the diagnosis of cancer [3]. Granular cell tumors are rare tumors of neurogenic or Schwann cell origin and hence can present in virtually any tissue with nerve cells.…”

Section: Discussionmentioning

confidence: 99%

“…Changes in the vulva are often subtle, difficult to recognize by the patient and can be overlooked [2]. Discussion of vulvar health, a thorough search for vulvar abnormalities and a low threshold for vulvar biopsy, is important in preventing diagnostic delays of important vulvar disease such as vulvar cancers [3]. We present herein a case of granular cell tumor of the vulva, a rare neoplastic lesion to highlight the importance of careful vulvar inspection during the annual well-woman examination.…”

Section: Introductionmentioning

confidence: 99%

Incidental Diagnosis of Granular Cell Tumor of Vulva: Importance of Discussing Vulvar Health at the Annual Well-Woman Examination

et al. 2015

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Granular cell tumors are rare tumors of neurogenic or Schwann cell origin and are known to involve the vulva. The objective of this case is to highlight the importance of careful vulvar examination during the annual well-woman examination by presenting a case of an incidental finding of granular cell tumor of the vulva. A 55-year-old African American female was noted to have an incidental finding of a 2 × 2 cm slow growing right vulvar lump at her yearly gynecologic exam. The lesion was excised and the histopathology was consistent with a benign granular cell tumor of the vulva. Immunostaining was positive for S100 and neuron-specific enolase. Asymptomatic vulvar masses can be the only presenting feature of a neoplastic process. Women may not seek medical attention due to embarrassment or lack of recognizing the importance of symptoms. This case report highlights such a scenario as a reminder to carefully examine the vulva during annual well-woman examination. A low threshold for biopsy can assist in diagnosing pre-invasive and invasive vulvar lesions.

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Analyzing Prior Clinical Events at Presentation in 102 Women With Vulvar Carcinoma: Evidence of Diagnostic Delays

Cited by 8 publications

References 0 publications

Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers

Risk factors for delayed presentation and referral of symptomatic cancer: evidence for common cancers

The diagnostic challenge of vulvar squamous cell carcinoma: Clinical manifestations and unusual human papillomavirus types

Incidental Diagnosis of Granular Cell Tumor of Vulva: Importance of Discussing Vulvar Health at the Annual Well-Woman Examination

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