Causes and risk factors of vulval cancer
What are the risk factors for vulval cancer?
The exact cause of vulval cancer is unknown. But some risk factors can increase the chances of developing it.
Having one or more risk factors does not mean you will get cancer. And if you do not have any risk factors, it does not mean you will not get vulval cancer.
If you are worried about vulval cancer and would like to talk to someone, we're here. You can:
- Call the Macmillan Support Line on 0808 808 00 00.
- Chat to our specialists online.
Age
The risk of developing vulval cancer increases with age. Most people who are diagnosed with vulval cancer are 70 or over. But the number of people younger than 60 getting diagnosed with vulval cancer has been increasing.
Vulval cancer in older people is usually linked to a skin condition called lichen sclerosus (LS).
Vulval cancer in younger people is often linked to human papilloma virus infection (HPV) and smoking.
HPV
The main risk factor for vulval cancer is an infection called the human papilloma virus (HPV). There are over 200 types of this virus. Some can affect the vulva and cause abnormal cell changes that may develop into vulval cancer. Most types of HPV are not linked to cancer. But high risk HPV can increase the risk of some types of cancer.
HPV is common, and most people are infected with it at some point. It can be passed on through any type of sexual contact. It is often shared between sexual partners. Using a condom or other barrier contraception may reduce the risk of infection with HPV, but it does not offer complete protection.
Most people infected by high risk HPV do not develop cancer. Usually, the body’s immune system gets rid of the virus naturally. There are no symptoms and often the virus does not cause damage. Most people will never know they had it.
In some people, the immune system does not clear the infection and the virus stays in the body for longer. We do not know exactly why this is. If the virus affects the vulva for longer, it can start to cause damage that may eventually cause cancer. Vulval cancer itself is not infectious. You cannot catch cancer or pass it on to other people.
The NHS routinely offers an HPV vaccine to all children aged 12 or 13 at school in the UK, to help prevent HPV infection. If you have missed having the vaccine, you can still have it until you are 25 years old. This reduces the risk of cancers caused by HPV. This is likely to help reduce the number of people getting usual-type vulval intraepithelial neoplasia (uVIN) and some types of vulval cancer in the future.
A weak immune system
The immune system helps protect the body from infection and illness. A weak immune system is less likely to get rid of infections like HPV. The immune system can be weakened by:
- smoking
- some medical conditions, such as human immunodeficiency virus (HIV)
- medicines used to suppress the immune system – for example, after an organ transplant.
If you are worried that you have a weakened immune system, talk to your GP or specialist nurse. They will be able to give you further advice.
Vulval skin conditions
Some skin conditions of the vulva can increase the risk of developing vulval cancer.
Lichen sclerosus (LS) and lichen planus (LP)
These are common, non-cancerous skin conditions. They can affect different parts of the body, but commonly affect the vulva. When they affect the skin of the vulva, they are known as vulval LS or vulval LP.
Fewer than 6 in every 100 women (less than 6%) who have vulval LS or LP develop vulval cancer. Over a long period of time, the inflammation caused by these skin conditions may increase the risk of cancer developing.
Paget's disease of the vulva
This condition causes abnormal changes in the cells that cover the skin of the vulva. It is rare and usually only affects people who have been through the menopause. In a small number of cases, cancer is found underneath the area where the Paget’s disease is.
Vulval intraepithelial neoplasia (VIN)
Vulval intraepithelial neoplasia (VIN) describes changes that happen in the skin that covers the vulva. If the changes become more severe, there is a chance cancer might develop after many years. VIN is called a pre-cancerous condition.
VIN is divided into 2 main types:
- VIN usual type (uVIN) is more common. It is usually linked to HPV. uVIN is also called high grade squamous intraepithelial lesion of the vulva (HSIL).
- VIN differentiated type (dVIN) is rarer. It often occurs together with other skin conditions that can affect the vulva, such as lichen sclerosus (LS) or lichen planus (LP). It is not usually linked to HPV.
Smoking
Smoking increases the risk of developing both VIN and vulval cancer. Smoking makes the immune system less effective and less able to get rid of HPV. This may be one of the reasons it increases the risk of vulval cancer.
Cervical intraepithelial neoplasia (CIN)
Cervical intraepithelial neoplasia (CIN) describes abnormal changes of the cells that line the cervix. High grade abnormal cell changes in the cervix (CIN 3) may increase the risk of developing vulval cancer. This may be related to shared risk factors, such as HPV infection and smoking. CIN3 may also be called a high grade squamous intraepithelial lesion (HSIL).
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our vulval cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Morrison J, Baldwin P, Hanna L, Andreou A, Buckley L, Durrant L, et al. British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: An update on recommendations for practice 2023. European Journal of Obstetrics and Gynaecology and Reproductive Biology. 2024;292: 210–238. Available from: www.doi.org/10.1016/j.ejogrb.2023.11.013 [accessed July 2026].
The Royal College of Radiographers. The Royal College of Radiologists expert panel recommendations for radiotherapy treatment for vulval cancer. 2024. Available from: www.rcr.ac.uk/media/l1zjohkm/rcr-vulval-cancer-treatment-recommendations.pdf [accessed July 2026]
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