科研之友
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摘要
Human papillomavirus (HPV) is a main risk factor for the development of vulvar and vaginal carcinomas. An increase in HPV infections could correlate with an increase in both tumor entities. Vaccination against HPV has now been available for several years. The aim of the study was to present an overview of etiological and epidemiological factors of vulvar and vaginal carcinomas. A search of the literature in well-established medical data base systems (MEDLINE, Cochrane database) was performed and a review of the available data concerning epidemiology and etiology from the last 30 years is presented. Within the last decade there has been an increase in HPV infections in younger women and in consequence an increase of the incidence of HPV-induced carcinomas of the vulva and vagina in younger patients and in the total population. Knowledge about epidemiological and etiological factors of vulvar and vaginal carcinomas is important not only concerning therapeutic decisions and type of therapy but also for the postoperative management of patients in the sense of risk stratification. Of particular importance are patients with a risk of recurrence of HPV negative vulvar carcinoma and differentiated vulvar intraepithelial neoplasia (d-VIN). Knowledge of the increased incidence of HPV-induced vulvar and vaginal carcinomas due to an increasing number of HPV infections worldwide should lead to a more intensive examination and inspection of the female genital region within cancer prevention programs. At the moment it remains to be seen whether HPV vaccination will influence the epidemiology and etiology of HPV-induced vulvar and vaginal carcinomas and the precursor lesions. This is greatly dependent on the implementation of the recommendations for vaccination in Germany and worldwide within the coming years.
