Malignant neoplasms of the vagina: A 30-year review from the Republic of Belarus

Objective: To perform a retrospective review of patients diagnosed with vaginal malignant neoplasms (VMN) in the Republic of Belarus. Methods: The Belarusian Cancer Registry was reviewed for patients diagnosed with VMN from 1990 to 2019. The data collected included age at diagnosis, demographic information, histology, stage, treatment modalities, and outcomes. Data were compared across decades (1990–1999, 2000–2009, and 2010–2019). Results: A total of 868 patients were diagnosed with VMN in Belarus between 1990 and 2019. The estimated age-standardized incidence rate of VMN per 100,000 female population increased from 0.1 in 1999 to 0.4 in 2019 (p < 0.05). The mortality rate for this period was 0.0–0.2 per 100,000 female population. Of all newly diagnosed cases of VMN, 70.9% (n = 615) lived in urban centers and 29.1% (n = 253) lived in rural areas. The most common histological type was squamous cell carcinoma, accounting for 78.4% of cases. The median age at diagnosis was 63.4 years (range, 15.0–87.0 years). When compared across the three decades, the number of stage I cases increased slightly more than twofold (from 19.1% to 38.5% for 1990–1999 to 2010–2019). Furthermore, the number of stage III cases decreased from 30.3% to 13.0% from 1990 to 1999 to 2010–2019. There were no significant changes in the number of patients diagnosed with stage II or IV disease over time. The overall 5-year survival rate for the entire group was 68.7 ± 5.1%, with no statistically significant difference between women living in urban centers vs. rural areas (67.8 ± 5.1% vs. 65.8 ± 10.4%; p = 0.99). However, there was a 26.2% increase in the 5-year survival rate for the entire group over the study period. This increase was higher for women living in rural areas (+61.7%) than for those in urban centers (+51.3%); p > 0.05. Furthermore, a comparison of 5-year adjusted survival rates between 2000 and 2015 showed increased survival for stages I, II, and III, with the most significant increase noted for stage III disease (2.4-fold increase). Conclusions: This retrospective study found that the survival rates of women with VMN in Belarus have improved over the past 30 years. This is likely due to improvements in early detection as well as improved approaches to treatment, particularly for those living in rural areas. Additional study is needed to further understand and improve the outcomes of women diagnosed with VMN in Belarus.