Medicare data show older women with vulvar lichen sclerosus are over 11 times more likely to develop vulvar squamous cell carcinoma or carcinoma in situ.
A study of 2.5 million women aged 65 years or older found a 0.7% prevalence of vulvar lichen sclerosus , and those with VLS had an 11-fold higher risk of developing vulvar squamous cell carcinoma or carcinoma in situ .
Analysis included 2,525,340 women aged 65 years or older with continuous Parts A, B, and D fee-for-service Medicare enrollment from October 2015 through December 2021.The prevalence of VLS was 0.7% ; 72.6% of these patients received appropriate treatment with topical corticosteroids or calcineurin inhibitors . Of the 47,499 VLS encounters, obstetrician-gynecologists managed 56.1%, while dermatologists managed 19.5% of cases. Of all patients with VLS, 1.2% subsequently developed VcSCC or VcSCCis; the risk for these two diagnoses was significantly higher than the risk in patients without VLS .“The 0.7% VLS prevalence in female Medicare beneficiaries is higher than the 0.05% prevalence in younger women and likely an underestimation, as VLS’s sensitive nature and healthcare access issues may prevent diagnosis,” the study authors noted. In an, Kelly H. Tyler, MD, of the Department of Dermatology, The Ohio State University Wexner Medical Center, Columbus, Ohio, wrote that dermatologists “are uniquely positioned to participate in the multidisciplinary management of patients with LS and vulvar cSCC and should advocate for this underserved patient population.”The study was led by Surya A. Veerabagu, MD, of The University of New Mexico in Albuquerque, New Mexico, and wasThe study’s generalizability is limited by its focus on Medicare beneficiaries aged 65 years or older, although VLS may be common in this population. Reliance on disease and treatment codes could have introduced errors.This research was supported by grants from the Cancer Prevention and Research Institute of Texas and the National Cancer Institute. Two study authors reported receiving grants from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and serving as treasurer of the Vulvar Dermatoses Research Consortium, the American College of Mohs Surgery Board of Directors, the American Society for Dermatologic Surgery Board of Directors, the National Comprehensive Cancer Network Non-Melanoma Skin Cancer Guideline Panel, and the High-Risk Squamous Cell Carcinoma Multicenter Collaborative. Tyler reported having no disclosures. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our
Malignant Skin Neoplasm Cancer Malignant Neoplasia Carcinoma Malignant Neoplasm Squamous Carcinoma Squamous Cancer Squamous Cell Carcinoma Squamous Cell Carcinoma Of The Skin Cancer Risk Vulvar Cancer Cancer Of The Vulva Lichen Sclerosus Et Atrophicus Lichen Sclerosus White-Spot Disease Lichen Sclerosus Et Atrophicus (LSA) Medicare Mohs Surgery Mohs Micrographic Surgery
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