Title thesis: Improving care for women with vulvar squamous (pre)malignancies

Loes van den Einden describes in her thesis opportunities for the further improvement of clinical care of women with vulvar (pre)malignancies with the focus on the diagnostic process and treatment. Vulvar lesions are sometimes difficult to diagnose by clinical doctors such as GPs, dermatologists, gynaecologists and pathologists because of the rarity of vulvar squamous (pre)malignancies with a variety of symptoms. Proper and timely treatment is important in order to minimise the morbidity and mortality caused by these lesions. In one of the studies presented in this thesis, the clinical use of the Vulva-Brush is described. The accuracy for (pre)malignant lesions with the use of a Vulva-Brush showed a sensitivity of 97% and a negative predictive value of 88%. Based on these results Van den Einden concluded that vulvar brush cytology is feasible and may be a first step in the development of a triage instrument to determine whether subsequent biopsy of a clinically suspicious lesion is necessary.