e12057 Background: Vulvar Paget's disease is difficult to diagnose early because this is a rare disease with an incidence of 10 patients per one million females per year and often ocurrs in elderly women aged 60-70 years old. A randomized controlled trial, meta-analysis and evidence-based medicine are not suitable methods of improving the prognosis of this disease. Vulvar Paget's disease is an adenocarcinoma in situ and a malignant disease. Since early diagnosis and treatment is necessary to improve prognosis, we extracted the causes of late diagnosis and proposals to improve prognosis from the literature. Methods: Literature review was performed through Japana Centra Revuo Medicina and PubMed. Ten articles including our study on 283 Asian women and seven articles on 363 Caucasian women were collected and examined according to patient age, interval between the initial symptom and the start of therapy, reason for delay in treatment and measures to prevent delay. Results: The mean age was 69.2 years (min∼max: 41∼88) in Asian women and 67.8 years (35∼88) in Caucasian women. The interval between the initial symptom and treatment was 3.38 years (0.0∼17.0) in Asian women and 1.93 years (0.1∼16.0) in Caucasian women. Many authors indicated the delay between the initial symptoms to treatment was related with patient age, slight initial symptoms of the disease, slow progression and resemblance to eczema, mycosis and dermatitis. They also indicated that awareness of the disease among patients and doctors should be increased in order to promote early diagnosis. Conclusions: The mean patient age did not significantly differ among Asian and Caucasian women. The interval before treatment was longer for Asian women than for Caucasian women, because red exanthema was more easily distinguished on white skin than on pigmented skin. As a gynecologist, we must consider this disease a malignancy and provide rapid diagnosis in order to begin treatment without delay. Moreover, since there are some patients who rely on self-medication or folk medicine rather than consulting a doctor, education about the existence of vulvar Paget's disease must also be provided to the general public. No significant financial relationships to disclose.