Case‐control study of cancer of the vulva

Risk factors for invasive squamous cell carcinoma of the vulva and vagina—Population‐based case–control study in Denmark

“…The risk factor associations we observed for VV-SCC vulva are generally in accordance with findings by Brinton et al, 8 who reported a high number of lifetime sexual partners, an early age at first sexual intercourse, low socioeconomic status, genital warts, previous abnormal pap smear and current tobacco smoking as risk factors for vulvar carcinoma. The uterine cervix is anatomically closer to the vagina than to the vulva, so our findings that DNA from cervical cancer-associated hrHPVs was present in 89% of the VV-SCC vagina cases vs. in only 50% of the VV-SCC vulva cases, and that a history of preinvasive or invasive cervical cancer was more strongly linked to VV-SCC vagina than to VV-SCC vulva both appear plausible.…”

“…Three studies reported that VV-SCC patients tend to have shorter education, lower household incomes and more often belong to lower social strata of society than controls. 2,8,16,17 Our findings regarding tobacco consumption are in agreement with prior reports All univariate odds ratios are adjusted for age at the time of the diagnosis.-2 Numbers and percentages of respondents who reported that they had had the disease (or HIV test) in question. In the calculation of odds ratios for these variables, respondents reporting no such disease (or HIV test) served as the reference group.-3 Numbers and percentages of respondents who reported that their male partner had had the disease in question.…”

“…Earlier reports have suggested a direct association between the lifetime number of male sexual partners and risk of VV-SCC. 2,[6][7][8]14 While women with 0 or 1 male sexual partner were at reduced risk in the present Danish setting we observed no difference in risk between women in the reference category reporting a lifetime number of 2-4 male sexual partners and those reporting 10 or more partners. Also, unlike a prior report, 2 we found no strong association between age at first sexual intercourse and risk of VV-SCC.…”

“…8,19,20 Tumour tissues from patients with VV-SCC are less often hrHPV-positive than those of patients with cervical carcinoma, which has led to Multivariate odds ratios for VV-SCC vulva are adjusted for age at the time of the diagnosis, anogenital warts, marital status, smoker status, cumulative alcohol consumption and years at school. Multivariate odds ratios for VV-SCC vagina are adjusted for age at the time of the diagnosis, genital washing before and after intercourse, preinvasive or invasive cervical cancer, smoker status and cumulative alcohol consumption.- 2 Respondents reporting no such disease served as the reference group.-3 Respondents reporting no such disease in their male partner served as the reference group.-4 One consumption-year is equivalent to 2 alcoholic drinks per day for 1 year.…”

“…2,6,7 Accordingly, a number of traditional cervical cancer risk factors, including lifetime number of male sexual partners, genital warts, tobacco smoking and low socioeconomic status have been reported to be particularly relevant to VV-SCCs associated with hrHPV infection. 4,[6][7][8][9] However, other, yet poorly defined etiologic factors that influence the risk of VV-SCC either without or in conjunction with hrHPV infection, must exist. 10 We undertook a nationwide case-control study in Denmark to explore these issues further and to address whether VV-SCCs with vaginal involvement (VV-SCC vagina ) differ etiologically from VV-SCCs restricted to the vulva (VV-SCC vulva ).…”