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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: Growths Linked to Venereal Virus Are on Rise in Women
Denise Grady
November 1, 2011
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 Institute (NCI).

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 cancers.

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 population.

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).