TOPLINE:

In a national retrospective cohort study in England, the incidence rate of vulval squamous cell carcinoma (VSCC) remained stable from 2013 to 2022, with diagnostic delays owing to poor awareness and clinical presentation challenges.

METHODOLOGY:

• Researchers conducted a retrospective analysis of 8930 cases of VSCC from the National Disease Registration Service "Get Data Out-Skin" dataset in England from 2013 to 2022.
• Outcomes included incidence, diagnostic stage, referral routes, treatment patterns, and 5-year net survival for 2014-2016 diagnoses.
• VSCC was the most common cutaneous SCC (cSCC) among Black vs White individuals (25.27% vs 2.84%). However, White women accounted for 92.24% of VSCC cases, whereas Black women accounted for only 1.29%.

TAKEAWAY:

• The crude incidence rate remained stable at 3.15 per 100,000 person-years (95% CI, 3.09-3.22), with an annual percentage change of 1.1% (95% CI, -0.40% to 2.60%).
• The pandemic impact analysis revealed a non-significant decrease in 2020 (incidence rate ratio [IRR], 0.92; 95% CI, 0.83-1.01; P = .067), followed by a significant rebound in 2021 (IRR, 1.13; 95% CI, 1.03-1.23; P = .009).
• Overall, 58.6% of VSCC cases were diagnosed at stages 1-2, 22.1% were diagnosed at stages 3-4, and 19.3% were diagnosed at an unknown stage; of these, 48.0% of stage 1-2 and 55.1% of stage 3-4 cancers were diagnosed by urgent referrals. Emergency presentations were significantly high for VSCC compared to those for non-genital cSCC (7.02% vs 1.85%; P < .0001). Emergency diagnoses of stages 3-4 were 11.79% from 2013 to 2020, and they were 16.11% in 2020.
• Overall, 59.25% of cases were primarily treated with excision surgery, including 77.21% of stage 1-2 lesions. The treatment of stage 3-4 VSCC included combinations or monotherapy of surgery, chemotherapy, or radiotherapy.
• The 5-year net survival showed marked differences by stage, with 78.2% (95% CI, 74.9%-81.4%) for stages 1-2 vs 33.1% (95% CI, 28.5%-37.8%) for stages 3-4.

IN PRACTICE:

"Although artificial intelligence and virtual consultations show promise in skin cancer triage, they present challenges in VSCC," the authors wrote. "Promoting awareness and early detection of vulval changes mitigate physical and psychosexual sequelae of late-stage management of this under reported cancer," they concluded.

SOURCE:

This study was led by Charlotte Sheern, Norwich Medical School, Norwich, England. It was published online on January 17, 2026, in the British Journal of Dermatology.

LIMITATIONS:

Incomplete data collection, particularly regarding surgical procedure codes, may have resulted in an underestimation of surgical excision proportions. The findings were also limited by the focus on self-identifying women in England, which affected generalisability to other populations.

DISCLOSURES:

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sectors. One author reported receiving support for research projects with Regeneron, Merck, and SkinAnalytics. Another author reported being an employee of the British Association of Dermatologists.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.