Vulvar Cancer: Risk Factors and Prevention

This section has been reviewed and approved by the Cancer.Net Editorial Board, 10/2012

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A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a woman’s risk of developing vulvar cancer:

Age. The majority of women diagnosed with vulvar cancer are older than 50. However, about 15% of women who develop vulvar cancer are younger than 40. Generally, vulvar cancer in younger women is associated with HPV infection (see below) and smoking. Vulvar cancer in older women is most often associated with lichen sclerosus (a rare skin condition; see below) or changes in certain genes.

HPV infection. Research indicates that infection with this virus is a risk factor for vulvar cancer. HPV is most commonly passed from person to person during sexual activity. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. HPV may be responsible for about one-third to two-thirds of vulvar cancers. Many types of cancer caused by HPV are associated with precancerous conditions (changes in cells that may, but do not always, become cancer) that develop before the cancer. HPV vaccines protect against certain strains of the virus. Learn more about HPV and cancer.

Smoking. Smoking may increase a woman’s risk of developing vulvar cancer if she has HPV.

Immune system deficiency. Women with lowered immune systems have a higher risk of developing vulvar cancer. A lowered immune system can be caused by immune suppression from corticosteroid medications, organ transplantation, treatment for other types of cancer, or human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS). When a woman has a lowered immune system, her body is more likely to develop infections, including an HPV infection.

Lichen sclerosus. This condition affects the vulvar skin, making it thin and itchy. About 4% of women with lichen sclerosus develop vulvar cancer.

Precancerous conditions. Precancerous conditions of the vulva, cervix, or vagina, or melanoma elsewhere on the body, can increase a woman’s risk of developing vulvar cancer.

Prevention and Early Detection

All women should have an annual gynecologic examination. During this exam, the doctor will take a family medical history and perform a general physical examination of the pelvis, during which the doctor will feel a woman’s uterus, vagina, cervix, and other reproductive organs to check for any unusual changes. Regular pelvic examinations can help detect cancer or precancerous conditions at an early stage:

In addition, research has shown that certain factors can help prevent vulvar cancer.

  • Delaying first sexual intercourse until the late teens or older
  • Avoiding sexual intercourse with multiple partners
  • Avoiding sexual intercourse with someone who has had many partners
  • Practicing safe sex, including condom use (although condoms cannot fully protect against HPV)
  • Having regular gynecologic examinations to find and treat precancerous conditions
  • Not starting to smoke
  • Quitting smoking, if a smoker

In 2008, the vaccine used to prevent cervical cancer for girls and women between ages 9 and 26 was also approved to prevent vulvar cancer. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. The vaccine protects against certain strains of the virus. The vaccine does not protect people who are already infected with HPV. Learn more about the HPV vaccine. Talk with your doctor for more information about the HPV vaccine.

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