INCIDENCE, RISK FACTORS, AND PREVENTION OF VULVAR CANCER IN WOMEN

Vulvar cancer is a relatively uncommon malignancy, yet it carries substantial morbidity because it affects a sensitive anatomical site, is frequently diagnosed at later stages, and often requires treatment that can be physically and psychologically burdensome. Epidemiologic evidence suggests that vulvar cancer incidence varies widely across regions and age groups, reflecting differences in population aging, human papillomavirus (HPV) exposure, screening practices for precursor lesions, and the prevalence of chronic vulvar inflammatory conditions. Contemporary understanding recognizes two major etiologic pathways: (1) HPV-associated disease, often preceded by usual-type vulvar intraepithelial neoplasia (uVIN/HSIL) and more common in younger women; and (2) HPV-independent disease, frequently linked to chronic dermatoses such as lichen sclerosus and preceded by differentiated VIN, typically occurring in older women and associated with poorer outcomes. Prevention therefore requires a dual strategy: primary prevention by HPV vaccination and risk-reduction behaviors, and secondary prevention through early recognition and treatment of precursor lesions and prompt evaluation of persistent vulvar symptoms. This article synthesizes current evidence on global incidence patterns, established and emerging risk factors, and practical prevention frameworks. Emphasis is placed on integrating HPV immunization, targeted education, clinician vigilance for chronic vulvar symptoms, and proactive management of vulvar dermatoses to reduce disease burden and improve women’s health outcomes.

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