Advertisement
Review Article| Volume 107, ISSUE 2, P329-355, March 2023

Ovarian, Uterine, and Vulvovaginal Cancers

Screening, Treatment Overview, and Prognosis
Published:January 02, 2023DOI:https://doi.org/10.1016/j.mcna.2022.10.016

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Medical Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Prifti C.
        • Kwolek D.
        • Growdon W.
        • et al.
        Gynecologic malignancies.
        in: Tilstra S.A. Kwolek D. Mitchell J.L. Sex- and gender-based women’s health. Springer International Publishing, Cham, Switzerland2020: 231-255
      1. Program NCIS. Cancer Stat Facts: Uterine Cancer.
        (Accessed October 16, 2022)
      2. Program NCIS. Cancer Stat Facts: Ovarian Cancer.
        (Accessed October 16, 2022)
      3. Society AC. Special Section: Rare Cancers in Adults.
        (Accessed October 16, 2022)
        • Desai A.
        • Xu J.
        • Aysola K.
        • et al.
        Epithelial ovarian cancer: An overview.
        World J Transl Med. 2014; 3: 1-8
        • Kuchenbaecker K.B.
        • Hopper J.L.
        • Barnes D.R.
        • et al.
        Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers.
        JAMA. 2017; 317: 2402-2416
        • Maccio A.
        • Madeddu C.
        Inflammation and ovarian cancer.
        Cytokine. 2012; 58: 133-147
        • Savant S.S.
        • Sriramkumar S.
        • O’Hagan H.M.
        The Role of Inflammation and Inflammatory Mediators in the Development, Progression, Metastasis, and Chemoresistance of Epithelial Ovarian Cancer.
        Cancers. 2018; 10: 251
        • King S.M.
        • Hilliard T.S.
        • Wu L.Y.
        • et al.
        The impact of ovulation on fallopian tube epithelial cells: evaluating three hypotheses connecting ovulation and serous ovarian cancer.
        Endocr Relat Cancer. 2011; 18: 627-642
        • Fathalla M.F.
        Incessant ovulation—a factor in ovarian neoplasia.
        Lancet. 1971; 298: 163
        • Havrilesky L.J.
        • Moorman P.G.
        • Lowery W.J.
        • et al.
        Oral contraceptive pills as primary prevention for ovarian cancer: a systematic review and meta-analysis.
        Obstet Gynecol. 2013; 122: 139-147
        • Beral V.
        • Doll R.
        • Hermon C.
        • et al.
        Ovarian cancer and oral contraceptives: collaborative reanalysis of data from 45 epidemiological studies including 23,257 women with ovarian cancer and 87,303 controls.
        Lancet. 2008; 371: 303-314
        • Olson S.
        Symptoms of ovarian cancer.
        Obstet Gynecol. 2001; 98: 212-217
        • Goff B.A.
        • Mandel L.S.
        • Melancon C.H.
        • et al.
        Frequency of symptoms of ovarian cancer in women presenting to primary care clinics.
        JAMA. 2004; 291: 2705-2712
        • Goff B.A.
        • Mandel L.S.
        • Drescher C.W.
        • et al.
        Development of an ovarian cancer symptom index: possibilities for earlier detection.
        Cancer. 2007; 109: 221-227
        • Buys S.S.
        • Partridge E.
        • Greene M.H.
        • et al.
        Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial.
        Am J Obstet Gynecol. 2005; 193: 1630-1639
        • Kurman R.J.
        • Visvanathan K.
        • Roden R.
        • et al.
        Early detection and treatment of ovarian cancer: shifting from early stage to minimal volume of disease based on a new model of carcinogenesis.
        Am J Obstet Gynecol. 2008; 198: 351-356
        • Kobayashi H.
        • Yamada Y.
        • Sado T.
        • et al.
        A randomized study of screening for ovarian cancer: a multicenter study in Japan.
        Int J Gynecol Cancer. 2008; 18: 414-420
        • Buys S.S.
        • Partridge E.
        • Black A.
        • et al.
        Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial.
        JAMA. 2011; 305: 2295-2303
        • Jacobs I.J.
        • Menon U.
        • Ryan A.
        • et al.
        Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial.
        Lancet. 2016; 387: 945-956
        • Padilla L.A.
        • Radosevich D.M.
        • Milad M.P.
        Accuracy of the pelvic examination in detecting adnexal masses.
        Obstet Gynecol. 2000; 96: 593-598
        • Padilla L.A.
        • Radosevich D.M.
        • Milad M.P.
        Limitations of the pelvic examination for evaluation of the female pelvic organs.
        Int J Gynaecol Obstet. 2005; 88: 84-88
        • Guirguis-Blake J.M.
        • Henderson J.T.
        • Perdue L.A.
        Periodic Screening Pelvic Examination: Evidence Report and Systematic Review for the US Preventive Services Task Force.
        JAMA. 2017; 317: 954-966
        • Wang Y.
        • Li L.
        • Douville C.
        • et al.
        Evaluation of liquid from the Papanicolaou test and other liquid biopsies for the detection of endometrial and ovarian cancers.
        Sci Transl Med. 2018; 10: eaap8793
        • US Preventive Services Task Force
        • Grossman D.C.
        • Curry S.J.
        • et al.
        Screening for Ovarian Cancer: US Preventive Services Task Force Recommendation Statement..
        JAMA. 2018; 319: 588-594
        • Daly M.B.
        • Pal T.
        • Berry M.P.
        • et al.
        Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology.
        J Natl Compr Canc Netw. 2021; 19: 77-102
        • Arora T.
        • Mullangi S.
        • Lekkala M.R.
        Ovarian cancer.
        in: StatPearls. StatPearls Publishing, 2022 (Available at:) (Accessed May 12, 2022)
        • Hacker N.F.
        • Rao A.
        Surgery for advanced epithelial ovarian cancer.
        Best Pract Res Clin Obstet Gynaecol. 2017; 41: 71-87
        • McGuire W.P.
        • Hoskins W.J.
        • Brady M.F.
        • et al.
        Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer.
        N Engl J Med. 1996; 334: 1-6
        • Ozols R.F.
        • Bundy B.N.
        • Greer B.E.
        • et al.
        Phase III trial of carboplatin and paclitaxel compared with cisplatin and paclitaxel in patients with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study.
        J Clin Oncol Off J Am Soc Clin Oncol. 2003; 21: 3194-3200
        • Tewari D.
        • Java J.J.
        • Salani R.
        • et al.
        Long-term survival advantage and prognostic factors associated with intraperitoneal chemotherapy treatment in advanced ovarian cancer: a gynecologic oncology group study.
        J Clin Oncol. 2015; 33: 1460-1466
        • Monk B.J.
        • Chan J.K.
        Is intraperitoneal chemotherapy still an acceptable option in primary adjuvant chemotherapy for advanced ovarian cancer?.
        Ann Oncol Off J Eur Soc Med Oncol. 2017; 28: viii40-viii45
        • Wenzel L.B.
        • Huang H.Q.
        • Armstrong D.K.
        • et al.
        • Gynecologic Oncology Group
        Health-related quality of life during and after intraperitoneal versus intravenous chemotherapy for optimally debulked ovarian cancer: a Gynecologic Oncology Group Study.
        J Clin Oncol. 2007; 25: 437-443
        • Young R.C.
        • Walton L.A.
        • Ellenberg S.S.
        • et al.
        Adjuvant therapy in stage I and stage II epithelial ovarian cancer. Results of two prospective randomized trials.
        N Engl J Med. 1990; 322: 1021-1027
        • Winter-Roach B.A.
        • Kitchener H.C.
        • Dickinson H.O.
        Adjuvant (post-surgery) chemotherapy for early stage epithelial ovarian cancer.
        Cochrane Database Syst Rev. 2009; 3: CD004706
        • Vergote I.
        • Trope C.G.
        • Amant F.
        • et al.
        Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer.
        N Engl J Med. 2010; 363: 943-953
        • Morrison J.
        • Haldar K.
        • Kehoe S.
        • et al.
        Chemotherapy versus surgery for initial treatment in advanced ovarian epithelial cancer.
        Cochrane Database Syst Rev. 2012; 8: CD005343
        • Walsh C.S.
        Latest clinical evidence of maintenance therapy in ovarian cancer.
        Curr Opin Obstet Gynecol. 2020; 32: 15-21
        • Liu J.F.
        • Konstantinopoulos P.A.
        • Matulonis U.A.
        PARP inhibitors in ovarian cancer: current status and future promise.
        Gynecol Oncol. 2014; 133: 362-369
        • LaFargue C.J.
        • Dal Molin G.Z.
        • Sood A.K.
        • et al.
        Exploring and comparing adverse events between PARP inhibitors.
        Lancet Oncol. 2019; 20: e15-e28
        • Garcia A.
        • Singh H.
        Bevacizumab and ovarian cancer.
        Ther Adv Med Oncol. 2013; 5: 133-141
        • Randall L.M.
        • Monk B.J.
        Bevacizumab toxicities and their management in ovarian cancer.
        Gynecol Oncol. 2010; 117: 497-504
        • Winter W.E.
        • Maxwell G.L.
        • Tian C.
        • et al.
        Prognostic factors for stage III epithelial ovarian cancer: a gynecologic oncology group study.
        J Clin Oncol. 2007; 25: 3621-3627
        • Klar M.
        • Hasenburg A.
        • Hasanov M.
        • et al.
        Prognostic factors in young ovarian cancer patients: an analysis of four prospective phase III intergroup trials of the AGO Study Group, GINECO and NSGO.
        Eur J Cancer Oxf Engl 1990. 2016; 66: 114-124
        • Bristow R.E.
        • Tomacruz R.S.
        • Armstrong D.K.
        • et al.
        Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis.
        J Clin Oncol. 2002; 20: 1248-1259
        • Salani R.
        • Backes F.J.
        • Fung Kee Fung M.
        • et al.
        Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: society of Gynecologic Oncologists recommendations.
        Am J Obstet Gynecol. 2011; 204: 466-478
        • Soyama H.
        • Takano M.
        • Miyamoto M.
        • et al.
        Factors favouring long-term survival following recurrence in ovarian cancer.
        Mol Clin Oncol. 2017; 7: 42-46
        • Stavraka C.
        • Ford A.
        • Ghaem-Maghami S.
        • et al.
        A study of symptoms described by ovarian cancer survivors.
        Gynecol Oncol. 2012; 125: 59-64
        • Siegel R.L.
        • Miller K.D.
        • Fuchs H.E.
        • et al.
        Cancer statistics, 2022.
        CA Cancer J Clin. 2022; 72: 7-33
        • Trope C.G.
        • Abeler V.M.
        • Kristensen G.B.
        Diagnosis and treatment of sarcoma of the uterus. A review.
        Acta Oncol. 2012; 51: 694-705
        • Network NCC
        NCCN clinical practice guidelines in oncology: uterine Neoplasms, version 1.2022.
        NCCN, 2022 (Available at:) (Accessed October 16, 2022)
        • National Cancer Institute
        Surveillance, epidemiology, and end results program. cancer stat facts: uterine cancer.
        (Available at:) (Accessed December 12, 2020)
        • Chelmow D.
        • Brooks R.
        • Cavens A.
        • et al.
        Executive summary of the uterine cancer evidence review conference.
        Obstet Gynecol. 2022; 139: 626-643
        • Sorosky J.I.
        Endometrial Cancer Obstet Gynecol. 2012; 120: 383-397
        • Kandoth C.
        • Schultz N.
        • et al.
        • Cancer Genome Atlas Research Network
        Integrated genomic characterization of endometrial carcinoma.
        Nature. 2013; 497: 67-73
        • Renehan A.G.
        • Zwahlen M.
        • Egger M.
        Adiposity and cancer risk: new mechanistic insights from epidemiology.
        Nat Rev Cancer. 2015; 15: 484-498
        • Smith R.A.
        • Eschenbach A.C.
        • Wender R.
        • et al.
        American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001–testing for early lung cancer detection.
        CA Cancer J Clin. 2001; 51: 38-75
        • Setiawan V.W.
        • Yang H.P.
        • Pike M.C.
        • et al.
        Type I and II endometrial cancers: have they different risk factors?.
        J Clin Oncol Off J Am Soc Clin Oncol. 2013; 31: 2607-2618
        • Rosen M.W.
        • Tasset J.
        • Kobernik E.K.
        • et al.
        Risk Factors for Endometrial Cancer or Hyperplasia in Adolescents and Women 25 Years Old or Younger.
        J Pediatr Adolesc Gynecol. 2019; 32: 546-549
        • Braithwaite R.S.
        • Chlebowski R.T.
        • Lau J.
        • et al.
        Meta-analysis of vascular and neoplastic events associated with tamoxifen.
        J Gen Intern Med. 2003; 18: 937-947
        • Committee Opinion No
        601: Tamoxifen and uterine cancer.
        Obstet Gynecol. 2014; 123: 1394-1397
        • Fung M.F.
        • Reid A.
        • Faught W.
        • et al.
        Prospective longitudinal study of ultrasound screening for endometrial abnormalities in women with breast cancer receiving tamoxifen.
        Gynecol Oncol. 2003; 91: 154-159
        • Bertelli G.
        • Venturini M.
        • Del Mastro L.
        • et al.
        Tamoxifen and the endometrium: findings of pelvic ultrasound examination and endometrial biopsy in asymptomatic breast cancer patients.
        Breast Cancer Res Treat. 1998; 47: 41-46
        • Braun M.M.
        • Overbeek-Wager E.A.
        • Grumbo R.J.
        Diagnosis and Management of Endometrial Cancer.
        Am Fam Physician. 2016; 93: 468-474
        • Meyer L.A.
        • Broaddus R.R.
        • Lu K.H.
        Endometrial cancer and Lynch syndrome: clinical and pathologic considerations.
        Cancer Control J Moffitt Cancer Cent. 2009; 16: 14-22
        • Luo J.
        • Beresford S.
        • Chen C.
        • et al.
        Association between diabetes, diabetes treatment and risk of developing endometrial cancer.
        Br J Cancer. 2014; 111: 1432-1439
        • Smith R.A.
        • Cokkinides V.
        • Brawley O.W.
        Cancer screening in the United States, 2012: a review of current American Cancer Society guidelines and current issues in cancer screening.
        CA Cancer J Clin. 2012; 62: 129-142
        • Crispens M.A.
        Endometrial and ovarian cancer in lynch syndrome.
        Clin Colon Rectal Surg. 2012; 25: 97-102
        • Kwon J.S.
        • Scott J.L.
        • Gilks C.B.
        • et al.
        Testing women with endometrial cancer to detect Lynch syndrome.
        J Clin Oncol. 2011; 29: 2247-2252
        • Manchanda R.
        • Saridogan E.
        • Abdelraheim A.
        • et al.
        Annual outpatient hysteroscopy and endometrial sampling (OHES) in HNPCC/Lynch syndrome (LS).
        Arch Gynecol Obstet. 2012; 286: 1555-1562
        • Felix A.S.
        • Cook L.S.
        • Gaudet M.M.
        • et al.
        The etiology of uterine sarcomas: a pooled analysis of the epidemiology of endometrial cancer consortium.
        Br J Cancer. 2013; 108: 727-734
        • Lavie O.
        • Barnett-Griness O.
        • Narod S.A.
        • et al.
        The risk of developing uterine sarcoma after tamoxifen use.
        Int J Gynecol Cancer. 2008; 18: 352-356
        • Mark R.J.
        • Poen J.
        • Tran L.M.
        • et al.
        Postirradiation sarcoma of the gynecologic tract. A report of 13 cases and a discussion of the risk of radiation-induced gynecologic malignancies.
        Am J Clin Oncol. 1996; 19: 59-64
        • Ricci S.
        • Stone R.L.
        • Fader A.N.
        Uterine leiomyosarcoma: Epidemiology, contemporary treatment strategies and the impact of uterine morcellation.
        Gynecol Oncol. 2017; 145: 208-216
        • Cote M.L.
        • Ruterbusch J.J.
        • Olson S.H.
        • et al.
        The Growing Burden of Endometrial Cancer: A Major Racial Disparity Affecting Black Women.
        Cancer Epidemiol Biomark Prev Publ Am Assoc Cancer Res Cosponsored Am Soc Prev Oncol. 2015; 24: 1407-1415
        • Zhou B.
        • Yang L.
        • Sun Q.
        • et al.
        Cigarette smoking and the risk of endometrial cancer: a meta-analysis.
        Am J Med. 2008; 121: 501-508.e3
        • Jareid M.
        • Thalabard J.C.
        • Aarflot M.
        • et al.
        Levonorgestrel-releasing intrauterine system use is associated with a decreased risk of ovarian and endometrial cancer, without increased risk of breast cancer. Results from the NOWAC Study.
        Gynecol Oncol. 2018; 149: 127-132
        • Iversen L.
        • Fielding S.
        • Ø Lidegaard
        • et al.
        Contemporary hormonal contraception and risk of endometrial cancer in women younger than age 50: A retrospective cohort study of Danish women.
        Contraception. 2020; 102: 152-158
        • Michels K.A.
        • Pfeiffer R.M.
        • Brinton L.A.
        • et al.
        Modification of the associations between duration of oral contraceptive use and ovarian, endometrial, breast, and colorectal cancers.
        JAMA Oncol. 2018; 4: 516-521
        • Karlsson B.
        • Granberg S.
        • Wikland M.
        • et al.
        Transvaginal ultrasonography of the endometrium in women with postmenopausal bleeding–a Nordic multicenter study.
        Am J Obstet Gynecol. 1995; 172: 1488-1494
        • Price F.V.
        • Chambers S.K.
        • Carcangiu M.L.
        • et al.
        CA 125 may not reflect disease status in patients with uterine serous carcinoma.
        Cancer. 1998; 82: 1720-1725
        • Patsner B.
        • Orr J.W.
        • Mann W.J.
        Use of serum CA 125 measurement in posttreatment surveillance of early-stage endometrial carcinoma.
        Am J Obstet Gynecol. 1990; 162: 427-429
        • Rose P.G.
        • Sommers R.M.
        • Reale F.R.
        • et al.
        Serial serum CA 125 measurements for evaluation of recurrence in patients with endometrial carcinoma.
        Obstet Gynecol. 1994; 84: 12-16
        • Giuntoli R.L.
        • Metzinger D.S.
        • DiMarco C.S.
        • et al.
        Retrospective review of 208 patients with leiomyosarcoma of the uterus: prognostic indicators, surgical management, and adjuvant therapy.
        Gynecol Oncol. 2003; 89: 460-469
        • Rossi E.C.
        • Kowalski L.D.
        • Scalici J.
        • et al.
        A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study.
        Lancet Oncol. 2017; 18: 384-392
        • Holloway R.W.
        • Abu-Rustum N.R.
        • Backes F.J.
        • et al.
        Sentinel lymph node mapping and staging in endometrial cancer: A Society of Gynecologic Oncology literature review with consensus recommendations.
        Gynecol Oncol. 2017; 146: 405-415
        • Walker J.L.
        • Piedmonte M.R.
        • Spirtos N.M.
        • et al.
        Recurrence and survival after random assignment to laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer: Gynecologic Oncology Group LAP2 Study.
        J Clin Oncol. 2012; 30: 695-700
        • Gunderson C.C.
        • Fader A.N.
        • Carson K.A.
        • et al.
        Oncologic and reproductive outcomes with progestin therapy in women with endometrial hyperplasia and grade 1 adenocarcinoma: a systematic review.
        Gynecol Oncol. 2012; 125: 477-482
        • Gallos I.D.
        • Yap J.
        • Rajkhowa M.
        • et al.
        Regression, relapse, and live birth rates with fertility-sparing therapy for endometrial cancer and atypical complex endometrial hyperplasia: a systematic review and metaanalysis.
        Am J Obstet Gynecol. 2012; 207: 266.e1-12
        • Slomovitz B.M.
        • Jiang Y.
        • Yates M.S.
        • et al.
        Phase II study of everolimus and letrozole in patients with recurrent endometrial carcinoma.
        J Clin Oncol. 2015; 33: 930-936
        • Oza A.M.
        • Elit L.
        • Tsao M.S.
        • et al.
        Phase II study of temsirolimus in women with recurrent or metastatic endometrial cancer: a trial of the NCIC Clinical Trials Group.
        J Clin Oncol. 2011; 29: 3278-3285
        • Oaknin A.
        • Tinker A.V.
        • Gilbert L.
        • et al.
        Clinical activity and safety of the anti-programmed death 1 monoclonal antibody dostarlimab for patients with recurrent or advanced mismatch repair-deficient endometrial cancer: a nonrandomized phase 1 clinical trial.
        JAMA Oncol. 2020; 6: 1766-1772
        • Azad N.S.
        • Gray R.J.
        • Overman M.J.
        • et al.
        Nivolumab is effective in mismatch repair-deficient noncolorectal cancers: results from arm Z1D-A subprotocol of the NCI-MATCH (EAY131) study.
        J Clin Oncol. 2020; 38: 214-222
        • Marabelle A.
        • Le D.T.
        • Ascierto P.A.
        • et al.
        Efficacy of Pembrolizumab in Patients With Noncolorectal High Microsatellite Instability/Mismatch Repair-Deficient Cancer: Results From the Phase II KEYNOTE-158 Study.
        J Clin Oncol. 2020; 38: 1-10
        • Marabelle A.
        • Fakih M.
        • Lopez J.
        • et al.
        Association of tumour mutational burden with outcomes in patients with advanced solid tumours treated with pembrolizumab: prospective biomarker analysis of the multicohort, open-label, phase 2 KEYNOTE-158 study.
        Lancet Oncol. 2020; 21: 1353-1365
        • Makker V.
        • Rasco D.
        • Vogelzang N.J.
        • et al.
        Lenvatinib plus pembrolizumab in patients with advanced endometrial cancer: an interim analysis of a multicentre, open-label, single-arm, phase 2 trial.
        Lancet Oncol. 2019; 20: 711-718
        • Zivanovic O.
        • Jacks L.M.
        • Iasonos A.
        • et al.
        A nomogram to predict postresection 5-year overall survival for patients with uterine leiomyosarcoma.
        Cancer. 2012; 118: 660-669
        • Atri M.
        • Zhang Z.
        • Dehdashti F.
        • et al.
        Utility of PET/CT to evaluate retroperitoneal lymph node metastasis in high-risk endometrial cancer: results of ACRIN 6671/GOG 0233 trial.
        Radiology. 2017; 283: 450-459
        • Henley S.J.
        • Miller J.W.
        • Dowling N.F.
        • et al.
        Uterine Cancer Incidence and Mortality - United States, 1999-2016.
        MMWR Morb Mortal Wkly Rep. 2018; 67: 1333-1338
        • American Cancer Society
        Cancer facts & figures.
        (Available at:) (Accessed July 1, 2021)
        • Madison T.
        • Schottenfeld D.
        • James S.A.
        • et al.
        Endometrial cancer: socioeconomic status and racial/ethnic differences in stage at diagnosis, treatment, and survival.
        Am J Public Health. 2004; 94: 2104-2111
        • Long B.
        • Liu F.W.
        • Bristow R.E.
        Disparities in uterine cancer epidemiology, treatment, and survival among African Americans in the United States.
        Gynecol Oncol. 2013; 130: 652-659
        • Bregar A.J.
        • Alejandro Rauh-Hain J.
        • Spencer R.
        • et al.
        Disparities in receipt of care for high-grade endometrial cancer: A National Cancer Data Base analysis.
        Gynecol Oncol. 2017; 145: 114-121
        • Rauh-Hain J.A.
        • Buskwofie A.
        • Clemmer J.
        • et al.
        Racial disparities in treatment of high-grade endometrial cancer in the Medicare population.
        Obstet Gynecol. 2015; 125: 843-851
        • Randall T.C.
        • Armstrong K.
        Differences in treatment and outcome between African-American and white women with endometrial cancer.
        J Clin Oncol Off J Am Soc Clin Oncol. 2003; 21: 4200-4206
        • Fleury A.C.
        • Ibeanu O.A.
        • Bristow R.E.
        Racial disparities in surgical care for uterine cancer.
        Gynecol Oncol. 2011; 121: 571-576
        • Kaspers M.
        • Llamocca E.
        • Quick A.
        • et al.
        Black and Hispanic women are less likely than white women to receive guideline-concordant endometrial cancer treatment.
        Am J Obstet Gynecol. 2020; 223: 398.e1-398.e18
        • Huang A.B.
        • Huang Y.
        • Hur C.
        • et al.
        Impact of quality of care on racial disparities in survival for endometrial cancer.
        Am J Obstet Gynecol. 2020; 223: 396.e1-396.e13
        • Rodriguez V.E.
        • LeBrón A.M.W.
        • Chang J.
        • et al.
        Racial-ethnic and socioeconomic disparities in guideline-adherent treatment for endometrial cancer.
        Obstet Gynecol. 2021; 138: 21-31
        • Whetstone S.
        • Burke W.
        • Sheth S.S.
        • et al.
        Health disparities in uterine cancer: report from the uterine cancer evidence review conference.
        Obstet Gynecol. 2022; 139: 645-659
        • Yagi A.
        • Ueda Y.
        • Kakuda M.
        • et al.
        Descriptive epidemiological study of vaginal cancer using data from the Osaka Japan population-based cancer registry: Long-term analysis from a clinical viewpoint.
        Medicine (Baltimore). 2017; 96
        • Stroup A.M.
        • Harlan L.C.
        • Trimble E.L.
        Demographic, clinical, and treatment trends among women diagnosed with vulvar cancer in the United States.
        Gynecol Oncol. 2008; 108: 577-583
        • Yang J.
        • Delara R.
        • Magrina J.
        • et al.
        Management and outcomes of primary vaginal Cancer.
        Gynecol Oncol. 2020; 159: 456-463
        • Saraiya M.
        • Watson M.
        • Wu X.
        • et al.
        Incidence of in situ and invasive vulvar cancer in the US, 1998-2003.
        Cancer. 2008; 113: 2865-2872
        • Wu X.
        • Matanoski G.
        • Chen V.W.
        • et al.
        Descriptive epidemiology of vaginal cancer incidence and survival by race, ethnicity, and age in the United States.
        Cancer. 2008; 113: 2873-2882
        • HP N.
        • Bulten J.
        • Hollema H.
        • et al.
        Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma.
        Mod Pathol. 2011; 24: 297-305
        • Faber M.T.
        • Sand F.L.
        • Albieri V.
        • et al.
        Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva.
        Int J Cancer. 2017; 141: 1161-1169
        • Pitkin R.M.
        • Herbst A.L.
        • Kurman R.J.
        • et al.
        Vaginal and cervical abnormalities after exposure to stilbestrol in utero.
        Obstet Gynecol. 2003; 102 (Obstet Gynecol 1972;40:287-298): 222
      4. Committee Opinion No.675: Management of Vulvar Intraepithelial Neoplasia published correction appears in Obstet Gynecol. 2017. Obstet Gynecol. 2016;128(4):e178–e182.

        • Gadducci A.
        • Fabrini M.G.
        • Lanfredini N.
        • et al.
        Squamous cell carcinoma of the vagina: natural history, treatment modalities and prognostic factors.
        Crit Rev Oncol Hematol. 2015; 93: 211-224
        • Jentschke M.
        • Hoffmeister V.
        • Soergel P.
        • et al.
        Clinical presentation, treatment and outcome of vaginal intraepithelial neoplasia.
        Arch Gynecol Obstet. 2016; 293: 415-419
        • National Comprehensive Cancer Network
        Vulvar Cancer (Version 1.2022).
        (Available at:) (Accessed May 22, 2022)
        • Tergas A.I.
        • Tseng J.H.
        • Bristow R.E.
        Impact of race and ethnicity on treatment and survival of women with vulvar cancer in the United States.
        Gynecol Oncol. 2013; 129: 154-158
        • Chase D.M.
        • Lin C.C.
        • Craig C.D.
        • et al.
        Disparities in Vulvar Cancer Reported by the National Cancer Database: Influence of Sociodemographic Factors.
        Obstet Gynecol. 2015; 126: 792-802
        • Hacker N.F.
        • Eifel P.J.
        • van der Velden J.
        Cancer of the vagina.
        Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. 2012; 119: S97-S99
        • Di Donato V.
        • Bellati F.
        • Fischetti M.
        • et al.
        Vaginal cancer.
        Crit Rev Oncol Hematol. 2012; 81: 286-295
        • Maggino T.
        • Landoni F.
        • Sartori E.
        • et al.
        Patterns of recurrence in patients with squamous cell carcinoma of the vulva. A multicenter CTF Study.
        Cancer. 2000; 89 (2-4): 116-122
        • National Cancer Institute
        SEER cancer statistics factsheets: vulvar cancer.
        (Available at:) (Accessed May 22, 2022)
        • National Cancer Institute
        Surveillance, Epidemiology, and End Results (SEER) Program Populations (1969-2020).
        (Available at:) (Accessed May 22, 2022)
        • Frega A.
        • French D.
        • Piazze J.
        • et al.
        Prediction of persistent vaginal intraepithelial neoplasia in previously hysterectomized women by high-risk HPV DNA detection.
        Cancer Lett. 2007; 249: 235-241
        • Salani R.
        • Khanna N.
        • Frimer M.
        • et al.
        An update on post-treatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: Society of Gynecologic Oncology (SGO) recommendations.
        Gynecol Oncol. 2017; 146: 3-10
        • Gonzalez Bosquet J.
        • Magrina J.F.
        • Gaffey T.A.
        • et al.
        Long-term survival and disease recurrence in patients with primary squamous cell carcinoma of the vulva.
        Gynecol Oncol. 2005; 97: 828-833