By Richard Barakat FACS, Andrew Berchuck, Maurie Markman MD, Marcus E. Randall MD FACR
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7 per 100,000 women in the SEER areas for the period 2000 to 2004. 0 per 100,000 for Blacks vs. 7 per 100,000 for Whites), but the reasons for the discrepancy are unknown. During 2012 it is estimated that 2,680 women developed the disease and 840 died from it (1). The average 5-year survival rate is 52% for Whites (50% for all races). The majority of vaginal cancers are squamous cell carcinomas and occur in the upper part of the vagina. Vaginal cancer is primarily a disease of older women, with almost 60% occurring among women 60 years of age or older (324).
These findings may support a role for genetic EPI DEM IOLOGY OF GYN ECOLOGIC CANCERS 21 factors or immunologic factors related to the histocompatibility of maternal and trophoblastic tissues. Menstrual, Reproductive, and Anthropometric Risk Factors In several studies that have adjusted for the effects of late maternal age, parous women have remained at a substantially reduced risk of GTD compared with nulliparous women, with some evidence of further reductions in risk with multiple births (350,352,353).
A proposed mechanism involves nests of abnormal cells of müllerian duct origin, which are stimulated by endogenous hormones during puberty and promoted into adenocarcinomas. GESTATIONAL TROPHOBLASTIC DISEASES Gestational trophoblastic diseases (GTDs) (which include hydatidiform moles, invasive moles, and choriocarcinoma) encompass a range of interrelated conditions characterized by abnormal growth of chorionic tissues with various propensities for local invasion and metastasis (334,335). Hydatidiform moles can be either complete or partial and have distinctive pathologies and etiologies.