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Vulvar cancer is an uncommon malignancy. Vulvar cancer alarmed the public health problem in terms of the cost of diagnostic and medical treatments and psychical health of females. Our study aims to provide a thorough analysis of the global disease burden, related risk factors and temporal incidence trends of vulvar cancer in population subgroups. Data from Global Cancer Observatory and the Cancer Incidence in Five Continents Plus were used for the vulvar cancer incidence. Age‐standardized rates (ASR) were used to depict the incidence of vulvar cancer. The 10‐year trend of incidence was assessed using joinpoint regression with average annual percentage change and 95% confidence intervals in various age groups, while its correlations with risk factors were investigated using linear regression. Higher ASR were found in Western Europe (2.4), Northern America (1.9), Northern Europe (1.9), Australia and New Zealand (1.8) and Eastern Africa (1.4). The associated risk factors of higher vulvar cancer incidence were gross domestic product per capita, Human Development Index, higher prevalence of smoking, alcohol drinking, unsafe sex and human immunodeficiency virus infection. The overall trend of vulvar cancer incidence was increasing. An increasing trend was found in older females while a mixed trend was observed in younger females. The disease burden of vulvar cancer follows a bimodal pattern according to its two histologic pathways, affecting women in both developed and developing regions. Smoking cessation, sex education and human papillomavirus vaccination programs should be promoted among the general population. Subsequent studies can be done to explore the reasons behind the increasing trend of vulvar cancer. [ABSTRACT FROM AUTHOR]

Background: In the second stage of the electronic health record sharing system (eHRSS), a mobile application "eHealth app" was launched to further enhance collaborative care among the public sector, the private sector, the community, and the caregivers.Objective: This study aimed to investigate the factors associated with the downloading and utilization of the app, as well as the awareness, perception, and future improvement of the app.Methods: We collected 2,110 surveys, respondents were stratified into three groups according to their status of enrollment in the eHRSS, downloaded, and adopted eHealth app. We collected the data on social economics factors, variables of the Technology Acceptance Model (TAM) and Theory of Planned Behavior (TPB) Any factors identified as significant in univariate analysis (p<.20) will be included in a subsequent multivariable regression analysis model. All p values ≤.05 will be considered as statistically significant in multiple logistic regression analysis. The structural equation modelling was performed to identify interactions among the variables.Results: The respondents had an overall high satisfaction rate and a positive attitude toward continuing to adopt and recommend the app. However, he satisfaction rate among respondents who have downloaded but not adopted the app was relatively lower, few of them perceived the downloading and acceptance process are difficult. A high proportion of current users expressed a positive attitude about continuing to adopt and recommend the applications to friends, colleagues and family members. The behavioural intention strongly predicted the acceptance of the eHealth app (β=0.89, p<.001). Attitude (β=0.30, <.001) and perceived norm β=0.37, p<.001) played important roles in determining behavioral intention, which could predict the downloading and acceptance of the eHealth app (β=0.14, p<.001).Conclusions: Despite the high satisfaction rate among the respondents, privacy concerns and perceived difficulties in adopting the app were the major challenges of promoting eHealth. Further promotion could be made through doctors and publicity. For future improvement, comprehensive health records and tailored health information should be included.Clinicaltrial: [ABSTRACT FROM AUTHOR]

Objective Design Setting Population Methods Main Outcome Measures Results Conclusions This study aimed to investigate the incidence, risk factors and trends for vaginal cancer.Retrospective observational design.Data were collected from multiple sources, including the Global Cancer Observatory, Cancer Incidence in Five Continents Plus, Global Burden of Disease, World Bank and the United Nations.Individuals diagnosed with vaginal cancer.The study collected data on vaginal cancer from the specified sources. The age‐standardised rate (ASR) of vaginal cancer was calculated for different regions and age groups. Multivariable and univariable linear regression analyses were performed to examine the associations between risk factors and the incidence of vaginal cancer. Trend analysis was conducted using joinpoint regression analysis, and the average annual percentage change (AAPC) was calculated to quantify the temporal trend.The main outcome measures of the study were the incidence of vaginal cancer, risk factors associated with the disease and the trend of its incidence over time.There were 17 908 newly reported cases of vaginal cancer (ASR = 0.36, 95% CI 0.30–0.44) in 2020, with the highest ASRs reported in South–Central Asia and Southern Africa. Risk factors associated with a higher incidence of vaginal cancer included a higher prevalence of unsafe sex and human immunodeficiency virus (HIV) infection. The temporal trend showed an overall rising incidence globally, with Iceland (AAPC = 29.56, 95% CI 12.12–49.71), Chile (AAPC = 22.83, 95% CI 13.20–33.27), Bahrain (AAPC = 22.05, 95% CI 10.83–34.40) and the UK (AAPC = 1.40, 95% CI 0.41–2.39) demonstrating the most significant rising trends.The significant regional disparities and risk factors associated with vaginal cancer underscore the necessity for targeted interventions and education, particularly in regions with a lower human development index (HDI) and a higher prevalence of human papillomavirus (HPV) infection. The increasing incidence trend emphasises the need for enhanced HPV vaccination rates to prevent the development of vaginal cancer. [ABSTRACT FROM AUTHOR]