What is the average age of vulvar cancer diagnosis?

Average Age of Vulvar Cancer Diagnosis

The median age of diagnosis for vulvar cancer is 65-70 years, with approximately 50% of cases occurring in women over 70 years of age. 1

Age Distribution Patterns

Vulvar cancer predominantly affects older women, with distinct age-related patterns:

• Median age: 65-70 years 1
• Age distribution trends:
  • Approximately 50% of cases diagnosed in women ≥70 years 2
  • About 25% of cases in women 50-69 years 2
  • Only about 20% of cases in women <50 years 3

The proportion of vulvar cancer cases in older women has been increasing over time:

• Cases in women >65 years increased from 36.62% (1992-1996) to 49.82% (2012-2015) 3
• Cases in women <50 years decreased from 42.05% (1992-1996) to 19.75% (2012-2015) 3

Age-Related Risk Factors

The age distribution of vulvar cancer reflects two distinct disease pathways:

1. HPV-related vulvar cancer:

   • More common in younger women (<50 years)
   • Associated with human papillomavirus infection
   • Often preceded by vulvar intraepithelial neoplasia (VIN) 1

2. Non-HPV related vulvar cancer:

   • More common in older women (>70 years)
   • Associated with chronic inflammatory conditions
   • Represents approximately 50% of vulvar squamous cell carcinomas 1, 2

Clinical Implications of Age

Age significantly impacts disease presentation and outcomes:

• Older patients (≥70 years) typically present with:

  • More advanced tumor stages
  • Larger tumor diameter
  • Poorer performance status
  • Higher rates of nodal involvement
  • More frequent HPV-negative tumors 2

• Prognosis by age group (2-year disease-free survival):

  • <50 years: 81.1%
  • 50-69 years: 65.8%
  • ≥70 years: 59.3% 2

Screening and Detection Considerations

The increasing age at diagnosis has important screening implications:

• Vulvar examination is often neglected in older women
• Medical societies have moved away from recommending routine pelvic examinations in asymptomatic women >65 years
• This may contribute to later-stage detection of vulvar cancer in older women 3

Global Epidemiology

The age distribution pattern is consistent across different populations:

• European data shows a mean age of 72 years for vulvar cancer diagnosis 4
• Age-standardized mortality rates increase significantly with age 4, 5

The increasing incidence of vulvar cancer in older women, coupled with the shift away from routine gynecologic examinations in this age group, highlights the importance of maintaining vigilance for vulvar cancer symptoms in elderly patients.