Selected epidemiological time trends of vulvar carcinoma in Israel

Recently, considerable demographic changes have occurred in Israel. The purpose of the present population-based nationwide epidemiological study of carcinoma of the vulva was to assess changes over time in incidence, relative frequency, age pattern and ethnic distribution. The study group included all 257 Jewish females with histologically confirmed neoplasms of the vulva diagnosed in Israel during the ten year period from 1985 to 1994. Data were obtained from the Israeli Cancer Registry and compared with data from a previous study covering a 13 year period (1961 to 1973). The relative frequency of carcinoma in situ (CIS) of the vulva increased significantly during the later period (from 5.4% to 12.8%), while that of invasive vulvar carcinoma declined significantly (from 80.6% to 69.6%). Regarding invasive vulvar carcinoma, a significant decrease in the age-adjusted standardized rates and in the mean annual incidence rate in the 70+ age group was found. The ethnic distribution pattern of invasive vulvar carcinoma did not change and remained similar to that of cervical carcinoma, namely a trend for higher incidence among women born in North Africa. The increased frequency of vulvar CIS is attributed mainly to a greater propensity to perform vulvar biopsies. The possibility of a consequent decline of vulvar carcinoma cannot be ruled out.