Deck 25: Epidemiology of Vaginal, Vulvar, Anal Cancer

Question 1

Epidemiologic features of vaginal, vulvar, and anal cancer are similar to cervical cancer since all are etiologically linked to infection of the respective tissues by oncogenic strains of human papilloma virus (HPV).

Answer 1

True

Question 2

Worldwide in 2018, cancers of the vagina, vulva, and anus were diagnosed in 90,180 women and caused 32,795 deaths.

Answer 2

True

Question 3

Anal cancer also afflicted 20,196 men in 2018, causing an additional 9,618 deaths in the male population.

Answer 3

True

Question 4

In contrast to cervical cancer, malignancies of the vagina and vulva are relatively rare and account for less than 0.5% of all female cancers and less than 5% of malignancies of the female genital tract.

Question 5

Most vaginal, vulvar, and anal malignancies (90-95%) are squamous cell carcinomas that arise from the stratified epithelium that covers these anatomic sites.

Question 6

The Population Attributable Fraction is an estimate of the proportion of cases of a specific disease (cancer) that could theoretically be avoided if exposure to a specific risk factor (such as HPV infection) was eliminated.

Question 7

Approximately two-thirds of cases of vaginal, vulvar, and anal cancer are attributable to infection by oncogenic strains of HPV.

Question 8

Co-infection by HIV has no effect on the development of HPV-related malignancies of the anogenital tract.

Question 9

Development of clear cell adenocarcinomas of the vagina in young girls has been causally linked to in utero exposure to diethylstilbestrol (DES).

Question 10

Cigarette smoking is not a risk factor for vaginal, vulvar, or anal cancer.

Question 11

The simplex type of vulvar carcinoma is linked to which of the following conditions?

A) Condyloma
B) Lichen sclerosus
C) Adenomatous polyp
D) Fibroids

Question 12

All strains of HPV listed below have been linked to the development of vaginal, vulvar, and anal cancer except:

A) HPV16.
B) HPV18.
C) HPV33.
D) HPV6.

Question 13

Risk factors for vaginal cancer include all of the following except:

A) high parity.
B) sexual activity with multiple partners at an early age.
C) chronic cigarette smoking.
D) estrogen replacement therapy in postmenopausal women.

Question 14

Infection by oncogenic HPV strains such as HPV16 and HPV18 has been estimated to account for what percentage of the cases of vaginal, vulvar, and anal cancer in women?

A) 66%
B) 80%
C) 90%
D) 100%

Question 15

Clear cell carcinoma of the vagina is caused by in utero exposure to which of the following compounds?

A) Nitrosamine
B) Ethanol
C) Diethylstilbestrol (DES)
D) Cannabis

Question 16

Describe the global burden of vaginal, vulvar, and anal cancer.

Question 17

Compare vaginal, vulvar, and anal cancer to cervical cancer.

Question 18

Discuss the pathogenesis of clear cell carcinoma of the vagina.

Question 19

Discuss the role of lichen sclerosus in the pathogenesis of vulvar cancer.

Question 20

Discuss the potential impact of vaccines in the prevention and control of HPV-related neoplasms of the anogenital tract.