Oncotarget

Clinical Research Papers:

Potential delay in the diagnosis of vulvar cancer and associated risk factors in women treated in German gynecological practices

Jennifer Muigai _, Louis Jacob, Konstantinos Dinas, Karel Kostev, Matthias Kalder

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Oncotarget. 2018; 9:8725-8730. https://doi.org/10.18632/oncotarget.23848

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Abstract

Jennifer Muigai1, Louis Jacob2, Konstantinos Dinas3, Karel Kostev1,4 and Matthias Kalder1

1Department of Gynecology and Obstetrics, Philipps-University Marburg, Marburg, Germany

2Faculty of Medicine, University of Paris 5, Paris, France

3Aristotle University of Thessaloniki, Faculty of Medicine, Thessaloníki, Greece

4Epidemiology, QuintilesIMS, Frankfurt am Main, Germany

Correspondence to:

Karel Kostev, email: karel.kostev@gmx.de

Keywords: vulvar cancer; delay; risk factors; vulva infection; vulva inflammation

Received: August 15, 2017     Accepted: November 05, 2017     Published: January 03, 2018

ABSTRACT

The goal of this study was to estimate a potential delay in the diagnosis of vulvar cancer and identify associated risk factors in women treated in gynecological practices in Germany. The current study sample included 1,652 women from 218 gynecological practices who received an initial diagnosis of vulvar cancer (ICD 10: C51) between January 2000 and December 2015 (index date). After applying several exclusion criteria, 505 non-cancer controls were matched (1:1) to 505 vulvar cancer cases based on age, health insurance status, and index date. The primary outcome was the delay in vulvar cancer diagnosis in women who had received an initial diagnosis of diseases of Bartholin's gland, inflammation of vagina and vulva, or other specified noninflammatory disorders of vulva, including atrophy, hypertrophy, and cyst. A logistic regression model was used to estimate the association between vulvar cancer and pre-defined diagnoses. The mean age was 60.8 years (SD = 15.6 years), and 4.8% of women had private health insurance coverage. Inflammation of vagina and vulva was diagnosed 328 days (SD = 95 days) prior to the detection of vulvar cancer. This delay was 186 days (SD = 196 days) in patients affected by diseases of Bartholin’s gland and 300 days (SD = 116 days) in those with other specified noninflammatory disorders of vulva including atrophy, hypertrophy, and cyst. The risk of vulvar cancer was positively associated with inflammation of vagina and vulva (OR = 2.28) and other specified noninflammatory disorders of vulva (OR = 5.39). The mean potential delay of vulvar cancer diagnosis ranged from 186 to 328 days.


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