**8. Screening for vaginal/vulva cancers**

Vulva and vaginal cancers account for 7% and 2% of all gynaecological cancers in the United Kingdom in with 80% of them been squamous cell carcinoma and 60% of vulva and 68% of vaginal cancers occur in developing countries (WHO 2009). In Nigeria cancers of the vulva and vagina constitute 1.3% and 1.4% of all gynaecological cancers (Clement et al 2013). It is worthy of note that 40 % of all vulva and vagina cancers are attributed to Human Papilloma virus in the United States of America with HPV 16 the main aetiological agent (Wu X et al 2008,Saraiya et al 2008). In developing countries like Nigeria HPV 16 and 36 have been identified in most cases of vaginal /vulva cancer (Thomas et al). This identification of this etiological agents makes one of the modalities of screening HPV genotype screening a possibility in addition visual inspection with acetic acid for vulva lesions. However there is no consensus on the modality of screening of vaginal and vulva lesions but it is advised that careful examination of vulva/perineal lesions must be undertaken and a biopsy of suspicious lesions taken. Despite the absence of supporting data e expert opinion recommend that annual visual inspection for vulva/vaginal lesions can be undertaken as part of the screening(Crum CP, 1992)
