Rising trends in HPV (+) & HPV (-) vulvar cancers among US non-Hispanic White and Hispanic White females 50 years and older.

person Ana Paola Mata Zetina Touro College of Osteopathic Medicine, New York, NY info_outline Ana Paola Mata Zetina, Sritha Rajupet, Theodore Strange, Meekoo Dhar, Lohitha Dhulipalla, Asmaa Mokhtar, Mario R Castellanos

Authors person Ana Paola Mata Zetina Touro College of Osteopathic Medicine, New York, NY info_outline Ana Paola Mata Zetina, Sritha Rajupet, Theodore Strange, Meekoo Dhar, Lohitha Dhulipalla, Asmaa Mokhtar, Mario R Castellanos Organizations Touro College of Osteopathic Medicine, New York, NY, Stony Brook Medicine, New York, NY, Northwell Staten Island University Hospital, Staten Island, NY, Staten Island University Hospital, Staten Island, NY, Northwell Health, Staten Island, NY Abstract Disclosures Research Funding No funding sources reported Background: Our prior studies show that vulvar cancer in older females is increasing in the US, aligning with lengthened USPSTF cervical cancer screening intervals. Most medical societies do not recommend genital exams post-cervical cancer screening, and data on vulvar cancer is lacking to make comprehensive screening strategies. We utilized the SEER database to examine vulvar cancer, HPV status, and race/ethnicity to better understand the characteristics of patients who develop cancer. Methods: We examined vulvar cancer cases & data from 2000-2020, as reported in the SEER database. Estimations of HPV-positive vulvar cancer rates by age were derived using HPV attribution percentages from the HPV Centre Information United States Full Report, with younger females defined as < 54 years. Correspondingly, cases not within this percentage were classified as HPV-negative. Results: From 2000 to 2020, vulvar cancer incidence in the US increased by 14%, with rates rising from 2.18 to 2.40 per 100,000. This rise was most pronounced in Non-Hispanic White females over 50, whose rates grew from 2.41 in 2000 to 2.87 in 2020, more than any other race and ethnicity. For HPV-positive vulvar cancer, there was a 1.5% decrease in cases among females under 54. In contrast, there were significant increases in the 55-64 and 65+ age groups, with 53% and 14% rises, respectively. Additionally, the 55-64 age group experienced a notable 23% increase in HPV-negative cases, and those 65+ had a 9% rise. Conclusions: This study is the first to show a significant increase in vulvar cancer among non-Hispanic White females, particularly those aged above 50 years. Surprisingly, we observed that HPV (+) cancers, typically associated with younger demographics, are continuing to occur in older females. This is concerning since the HPV vaccine, introduced in 2007, wasn't available for HPV prevention in females now over 50. Concurrently, there is a rise in HPV-negative vulvar cancers within these older age groups. The current guidelines don't recommend routine genital exams for females over 65, indicating that there may be an opportunity to reexamine this recommendation given the US vulvar cancer trends in older females.