This guideline addresses issues of referral for investigation and confirmation, diagnostic procedures and management of vulval carcinoma. The guideline covers all invasive vulval cancers of any histological type.
This is the first edition of this guideline.
It is a joint RCOG/British Gynaecological Cancer Society (BGCS) guideline.
Vulval cancer is rare. It is ranked as the 20th most common female cancer. The most recent mortality figures (2011) suggest a crude mortality rate of 1.3/100000 women.
By age group, the incidence trend has remained relatively stable over the last three decades, although the incidence in women aged 40–49 years has risen two-fold. This increase has been reflected in reports from other countries and has been ascribed to the effect of increasing human papillomavirus (HPV) infection.
Vulval cancer is a disease affecting predominantly elderly women and is uncommon below the age of 50 years. Comorbidities also increase with age which may prove challenging when planning management.
As there will be occasions when clinical history and examination alone cannot exclude cancer or preinvasive disease, this document addresses issues of referral for investigation and confirmation, diagnostic procedures and management. The questions of follow-up and outcome assessment are also addressed.