Risk factors of vulval cancer

The cause of vulval cancer is unknown, but there are some risk factors that can increase a woman’s chance of developing it:

  • Age – about 8 out of 10 women who are diagnosed with vulval cancer are over the age of 60.
  • Vulval skin conditions – women with non-cancerous skin conditions such as vulval lichen sclerosus and vulval lichen planus have a higher risk of developing vulval cancer.
  • Human papilloma virus (HPV) – this is a common infection, usually passed between people during sex. Some types of HPV are linked to vulval cancer. Most women with HPV don’t develop any problems and their immune system quickly fights the virus.
  • Vulval intraepithelial neoplasia (VIN) – this is a pre-cancerous condition that occurs in the skin of the vulva. Sometimes VIN can develop into vulval cancer.
  • Paget’s disease of the vulva – this is a rare skin condition. In some women, cancer is found under the skin which is affected by Paget’s disease
  • Smoking – the risk of developing VIN and vulval cancer increases if you smoke.

Causes and risk factors of vulval cancer

The exact causes of vulval cancer are unknown. There are some risk factors that can increase a woman’s chances of developing it.


Age

The risk of developing vulval cancer increases with age. About 8 out of 10 women who are diagnosed with vulval cancer (80%) are over the age of 60. Vulval cancer in older women is usually linked to a skin condition called lichen sclerosus.

Vulval cancer is becoming more common in younger women, where it’s often linked to human papillomavirus infection (HPV).


Vulval skin conditions

Women who have non-cancerous skin conditions of the vulva, such as vulval lichen sclerosus or vulval lichen planus, have a higher risk of developing vulval cancer. About 3–5 out of every 100 women who have lichen sclerosus (3–5%) develop vulval cancer. It’s thought that over a long period of time the inflammation caused by these skin conditions increases the risk of cancer developing.


Human papillomavirus (HPV)

HPV is a very common infection. It is usually passed between people during sex. There are many different types of HPV, and each has a number. Some types (particularly 16, 18 and 31) are linked to vulval cancer and pre-cancerous changes called VIN.

Most women with HPV infection don’t have any problems, as their immune system quickly gets rid of the virus. But in a few women, the virus stays and may cause abnormal changes in the skin of the vulva, and sometimes vulval cancer.

A vaccination against HPV is offered to girls aged 12–13 in the UK. This protects against HPV types 16 and 18.

It may take several years to see whether this vaccination reduces the number of vulval cancers. This is because vulval cancers can take a long time to develop.


Vulval intraepithelial neoplasia (VIN)

This is a pre-cancerous condition that can occur in the skin of the vulva. In some women, VIN develops into vulval cancer. There are two types of VIN:

VIN usual type

This type is linked to HPV infection and mainly affects younger women under 50.

VIN differentiated

This type of VIN is linked to lichen sclerosus and more commonly affects women over 50.


Paget’s disease of the vulva

This condition causes abnormal changes in the cells that cover the skin of the vulva. It’s rare and usually only affects women who’ve been through the menopause. In a small number of women with Paget’s disease of the vulva, cancer is found underneath the area.


Smoking

Smoking increases the risk of developing both VIN and vulval cancer. The longer a woman smokes for and the more cigarettes she smokes, the greater the risk. Smoking makes the immune system less effective and less able to get rid of the HPV virus.

This may be one reason why it increases the risk of vulval cancer. If you are a smoker and want to stop, the section Giving up smoking has tips and advice.


Back to Potential causes of vulva cancer

Human papilloma virus (HPV)

Human papilloma virus (or HPV) is a common infection. Some types of HPV can increase the risk of developing cancer.