Cancer causes & control : CCC · 2026
The impact of absent vulvar cancer screening guidelines on outcomes of vulvar squamous cell carcinoma: a national cancer database study.
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Folino Grace, Byrne Elizabeth, Eiden Mary Kate, Vasa Mya, Silberstein Peter, DiBlasi Marco
Аннотация
PURPOSE: To analyze current vulvar squamous cell carcinoma (VSCC) data with respect to age groups and determine if gynecologic cancer screening guidelines address the burden of VSCC on the ≥ 65 cohort.
METHODS: Patient data from 2004 to 2021 was identified from the National Cancer Database using ICD-10 codes specific for the vulva, and ICD-O-3 histology codes for squamous cell carcinoma or premalignant vulvar intraepithelial neoplasia Grade III. GraphPad Prism and IBM SPSS were used to analyze variable frequency with cross analysis. Chi-squared tests, Kaplan-Meier survival curves with log-rank comparison, and Cox proportional hazard regression models were utilized for statistical analysis. For regression models of hazard ratios (HRs) and odds ratios (ORs), the 50-64-year-old cohort was used as a reference variable.
RESULTS: The patient population was 68,153. Mean overall survival decreased as age increased (≤ 49 years old was 184.9 months, 50-64 years old was 152.1 months, 65-74 years old was 107.3 months, and ≥ 75 years old was 57.7 months). The ≥ 75-year-old cohort had a 330% higher risk of mortality when compared to the reference variable (HR 4.3, p < 0.001), followed by the 65-74-year-old cohort (HR 1.96, p < 0.001). The ≥ 75 years old and 65-74-year-old cohorts had the highest likelihood of advanced VSCC (OR 1.91, p < 0.001 and OR 1.37, p < 0.001, respectively).
CONCLUSIONS: Patients ≥ 65 years old are significantly more likely to experience worse survival outcomes and higher stage diseases, indicating that a lack of screening protocols may influence VSCC outcomes.
METHODS: Patient data from 2004 to 2021 was identified from the National Cancer Database using ICD-10 codes specific for the vulva, and ICD-O-3 histology codes for squamous cell carcinoma or premalignant vulvar intraepithelial neoplasia Grade III. GraphPad Prism and IBM SPSS were used to analyze variable frequency with cross analysis. Chi-squared tests, Kaplan-Meier survival curves with log-rank comparison, and Cox proportional hazard regression models were utilized for statistical analysis. For regression models of hazard ratios (HRs) and odds ratios (ORs), the 50-64-year-old cohort was used as a reference variable.
RESULTS: The patient population was 68,153. Mean overall survival decreased as age increased (≤ 49 years old was 184.9 months, 50-64 years old was 152.1 months, 65-74 years old was 107.3 months, and ≥ 75 years old was 57.7 months). The ≥ 75-year-old cohort had a 330% higher risk of mortality when compared to the reference variable (HR 4.3, p < 0.001), followed by the 65-74-year-old cohort (HR 1.96, p < 0.001). The ≥ 75 years old and 65-74-year-old cohorts had the highest likelihood of advanced VSCC (OR 1.91, p < 0.001 and OR 1.37, p < 0.001, respectively).
CONCLUSIONS: Patients ≥ 65 years old are significantly more likely to experience worse survival outcomes and higher stage diseases, indicating that a lack of screening protocols may influence VSCC outcomes.