BACKGROUND AND PURPOSE:

• Lichen sclerosus (LS) is known to be associated with an increased risk for vulvar squamous cell carcinoma
  • However, association with overall mortality is not well known
• Halonen et al. (BJOG, 2020) assessed the incidence of LS in women and associated all-cause and cause-specific mortality

METHODS:

• Population-based descriptive study
• Participants
  • All Finnish women (1969 to 2012)
• Study design
  • Data on women with LS were collected from the Finnish Hospital Discharge Register
  • Dates and causes of death for the population were retrieved from Statistics Finland and the Finnish Cancer Registry
  • Population statistics derived from Statistics Finland
• Primary outcomes
  • Crude and age-adjusted incidence rates of LS
  • Standardized mortality ratios (SMRs)

RESULTS:

• Women with LS: 7,790  
• The age-adjusted incidence rate of LS increased from 2003 to 2010-2012
  • 2003: 14 per 100,000 women-years
  • 2010-2012: 22 per 100,000 women-years
  • Cumulative incidence of LS by 80 years: 1.6%
• Age-specific incidence rate was highest in postmenopausal women, but was also elevated in girls 5-9 years old
  • Postmenopausal women: 24 to 53 per 100,000
  • Girls 5-9 years old: 7 per 100,000
• All-cause mortality of women with LS was lower than in the general female population
  • SMR 0.84 (95% CI, 0.78 to 0.90)
• This reduction in all-cause mortality was mostly due to decreased mortality from
  • Circulatory diseases: SMR 0.80 (95% CI 0.72 to 0.89)
  • Dementia and Alzheimer’s disease: SMR 0.75 (95% CI, 0.62 to 0.88)
• Cancer mortality was similar to that of the general population
  • However, vulvar cancer mortality was increased: SMR 28.1 (95% CI, 19.3 to 39.4)

CONCLUSION:

• LS is common and the risk of manifesting this disorder by age 80 was 1.6%
• Risk for death due to circulatory diseases, and from dementia and Alzheimer’s disease, was decreased
• All-cause mortality was lower in women with LS, but mortality from vulvar cancer was increased
• Authors suggest various explanations for decreased all-cause mortality including
  • Healthier lifestyle in LS group (e.g. decreased chance of death from lung cancer and alcohol related diseases)
  •  Patients with LS may be seen more often in the healthcare system

Learn More – Primary Sources:

Incidence of lichen sclerosus and subsequent causes of death: a nationwide Finnish register study

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