P192 The global incidence of vulval cancer from 2000 to 2025: a systematic review

Abstract

Vulval cancer (VC) is a debilitating gynaecological malignancy, with poorer 5-year net survival rates than melanoma, breast cancer or prostate cancer. Worldwide, VC incidence rates vary due to population demographics, cultural attitudes towards vulval health and the prevalence of established risk factors. We conducted a systematic review of the global incidence rates and temporal trends of VC. OVID MEDLINE, CINHAL and Scopus were systematically searched on 6 December 2025, to identify ­population-based, epidemiological reports of VC incidence, published from 2000 to 025. CORE.ac.uk and ProQuest dissertations were used to identify grey literature. National incidence rates and temporal trends were extracted and synthesized narratively. Risk of bias was assessed using Joanna Briggs Institute’s checklist for prevalence studies. Thirteen reports across five continents were eligible for inclusion. The lowest age-standardized incidence rates (ASIR) of VC were observed in Asia: the ASIR in China in 2016 was 0.3 per 100 000 person-years, standardized to Segi’s world standard population. The highest rate was in Europe: in Norway during 2001–2010 the ASIR was 4.7 per 100 000 person-years, standardized to the Norwegian population. Vulval squamous cell carcinoma was the predominant histological subtype, with proportions highest in Europe (74–96%) and lowest in South Korea (51.4%). China did not report subtype data. Most countries observed significantly increasing temporal trends (Denmark, Germany, the Netherlands, Australia, South Korea, China and South Africa), whereas incidences elsewhere were stable (Sweden, Poland, Croatia). The results could not be pooled in a meta-analysis due to the heterogeneities of reporting methods, reference populations and histological subtypes of VC included. This review highlights upward trends and geographical variation in VC incidence globally despite human papillomavirus vaccination, with the highest incidence rates seen in Europe and the lowest in Asia. Women from low-income countries were under-represented in this review, due to limited availability of population-based reports. Worldwide continued monitoring is essential to inform evidence-based and culturally appropriate public health strategies.