Incidence, pathology and outcome of gynaecological cancer in patients under the age of 21 years in South-west England 1995-2004: comparison of data from regional, national and international registries.

We analysed the incidence, tumour types, management and outcome of gynaecological cancer diagnosed from 1995-2004 in females <21 years in south-west England. Data from the South West Cancer Intelligence Service were compared with those from regional and national registries. A total of 63 patients had gynaecological malignancies: 49 ovarian; nine cervical; the remainder vaginal, uterine or pelvic. The median age was 16 years. Germ cell tumours (26) and carcinomas (6) were the commonest primary ovarian and cervical tumours respectively. Most patients had fertility-sparing procedures. Only seven required re-operation. Information about chemoradiotherapy was incomplete. Four deaths occurred. All patients were followed >3 years and 68% >5 years, with 94% survival to date. Fertility preservation did not impair survival. Mortality is an inadequate indicator of outcome; cancer registries should record information on fertility and pregnancy outcomes, second tumours and long-term treatment-related complications. Improved management requires greater centralised assessment of histology, follow-up and adjuvant treatment.