New York Times (10.21.11) - Tuesday, November 01, 2011
The number of genital precancerous growths among women is
rising, with cases increasing fourfold between 1973 and 2000,
according to a report released Oct. 20 by the National Cancer
Vulvar intraepithelial neoplasia (VIN) form on the external
areas of the vulva, including the labia and clitoris, or on
the anus or thighs. The precancers do not always turn into
cancer, but doctors recommend removing them anyway since it is
impossible to predict which ones will advance; surgery, lasers
or drugs are used to remove the growths.
Most of the growths are linked to human papillomavirus (HPV),
an STD known to cause cervical, anal, penile, and oral
It is not known why VIN are increasing, though some doctors
suspect a concurrent rise in the number of people's sex
partners, resulting in more risk of HPV exposure. The immune
system fights off the infection in most people.
Dr. L. Stewart Massad, professor of gynecologic oncology at
Washington University in St. Louis and an NCI spokesperson,
said VIN is probably more common than actual cancer cases,
though no reliable national data exist. NCI's estimates were
based on studies from individual centers and from 2006 data
from cancer registries comprising about 14 percent of the US
Vaccination against the HPV strains linked to cervical cancer
and VIN is recommended before becoming sexually active.
NCI wants doctors to know about new changes to the
classification system for abnormal vulva growths, to avoid
unnecessary biopsies and surgeries. "There was concern about
overtreatment," said Massad.
The report, "Committee Opinion No. 509: Management of Vulvar
Intraepithelial Neoplasia," was published in the journal
Obstetrics & Gynecology (2011;118(5):1192-1194).