Vulvar Cancer Risk Factors and Prevention

Page Contents

Risk factors are things that raise your chances of getting a disease. For each person, there’s a mix of genetic, biological and lifestyle factors that play a part in vulvar cancer risk.

This form of cancer usually affects older people. Eighty percent of people with vulvar cancer are age 50 or older. Invasive vulvar cancer is more common after age 70.

Take Charge of Your Health

Talk to your primary care provider if you have symptoms that you think may be vulvar cancer. UW Medicine Primary Care can help you get started. Learn about Fred Hutch's relationship with UW Medicine.

Risk Factors for Vulvar Cancer

Besides age, these factors increase your risk for vulvar cancer:

  • Having high-risk human papillomavirus (HPV). There are more than 200 types of HPV. Some types cause warts. Some increase the risk for cancer of the vulva, cervix, vagina, penis, anus and throat. These types are called high-risk HPV. About 70% of vulvar cancers are caused by HPV, according to the National Cancer Institute.
  • Having had genital warts.
  • Having vulvar intraepithelial neoplasia (VIN). This means there are abnormal cells on the surface of the skin of your vulva. The cells aren’t cancer, but they may turn into cancer. Physicians sometimes call VIN stage 0 cancer. (Staging means finding out how far vulvar cancer has spread in your body.) VIN is also called vulvar squamous intraepithelial lesions (SIL).
  • Smoking. The increased risk is greater if you also have HPV, especially high-risk HPV.
  • Having HIV (human immunodeficiency virus). HIV can impair your body’s ability to fight off HPV and possibly cancer cells.
  • Having vulvar lichen sclerosis. This condition makes the skin of the vulva thin and itchy, and it may slightly increase your risk. Having a history of abnormal Pap tests (to check for cervical cancer or cell changes that may turn into cancer). Having had cervical cancer.
  • Having a history of abnormal Pap tests (to check for cervical cancer or cell changes that may turn into cancer).
  • Having had cervical cancer.

How Vulvar Cancer Can Be Prevented

You can take steps to reduce your risk for vulvar cancer.

  • Make choices that lower your chances of getting infected with HPV. We explain more about HPV and cancer prevention below.
  • Don’t smoke. If you smoke, it’s important to quit. Help is available. Talk with your primary cancer provider. They can help you make a plan to quit and find supportive resources that are right for you. There are medicines that can help as well, like nicotine replacement products and drugs to ease cravings and withdrawal symptoms. Fred Hutch Cancer Center has a free smartphone app called QuitBot that includes step-by-step guidance and virtual coaching.
  • See your primary care provider or gynecologist for regular checkups that include a pelvic exam and Pap test, even if you have no signs or symptoms. This is a chance to detect any problem early, even before abnormal cells turn into cancer. Ask your provider how often you should have a checkup. Contact them between checkups if you have any symptoms or concerns.
  • Do monthly self-exams of your vulva using a mirror. Look for anything that’s out of the ordinary, like changes in your skin color, irritation, bumps, growths or sores. If you notice anything, let your health care team know. These could be symptoms of precancer, cancer or another condition that needs treatment.

HPV and Cancer

It’s very common to have HPV. The virus is spread by skin-to-skin contact, and almost everyone who has been sexually active will be infected. You can have HPV without knowing it. In fact, while low-risk HPV may cause warts, high-risk HPV doesn’t cause symptoms. People without symptoms can still pass the virus to others.

In most people, the immune system clears the infection. But in some people, the body doesn’t control HPV well enough to clear it. Long-lasting infection with high-risk HPV can lead to precancerous changes in your cells and sometimes to cancer.

How to Prevent HPV

You can lower your risk of getting HPV by using condoms and having sexual contact with fewer people.

A vaccine called Gardasil can prevent infection with many types of HPV — including several types that cause cancer. Vaccination prevents 90% of cancers caused by HPV.

  • The vaccine is given as a series of shots, either two or three based on the person’s age.
  • Physicians recommend that young people get the vaccine early in life, ideally at age 11 or 12, before they become sexually active. It can be given as early as age 9.
  • Older teens and adults can also get the vaccine. Usually, it’s not given after age 26 because most unvaccinated people already have HPV by that age.

If you’re 26 or younger and tested positive for HPV, it might still be a good idea to get the vaccine. It won’t cure the HPV you already have. But it may protect you against types of HPV you don’t have, including high-risk types.

Talk with your primary care provider or gynecologist about whether the vaccine is right for you (and for your children if you’re a parent).

How Fred Hutch Is Researching Vulvar Cancer Prevention

Fred Hutch researcher Denise Galloway, PhD, made critical discoveries in linking HPV to several cancers and in designing clinical trials for the HPV vaccine. She continues to research the impact of the vaccine and is working to find out if a single dose can provide long-term immunity.

Vulvar Cancer Risk Factors and Prevention FAQ

There’s a test to check for some types of HPV in the cervix (the narrow lower end of the uterus that extends into the vagina). It can tell if this part of your body is infected. It can’t tell if you have an HPV infection in another part of your body, like an oral or anal infection, or if you have cancer or precancerous changes.

Typically, the test is done on a sample of cells taken during a pelvic exam, often at the same time as a Pap test.

If you have HPV, there’s no cure. But there are ways to treat symptoms like warts and cell changes that could become cancer.

  • See your primary care provider or gynecologist for regular checkups that include a pelvic exam and Pap test.
  • If you have symptoms of vulvar cancer or any other gynecologic or reproductive concern, see your primary care provider or gynecologist. They can help you find out the cause and get any care you might need.

Most people with VIN/SIL will never get cancer. But there’s no way for your physician to know if you will or not. So, if you’ve been diagnosed, it’s important to follow up with your health care team. They may recommend that you:

  • Have regular exams or testing to check for changes
  • Have treatment that might prevent cancer

Treatments to get rid of VIN include chemotherapy ointment (fluorouracil, 5-FU), immunotherapy cream (imiquimod), laser surgery and surgery to remove the top layer of skin (skinning vulvectomy).

Learn more about these in the section on vulvar cancer treatment.

Other than quitting smoking and reducing your risk for HPV, physicians and researchers don’t have recommendations for vulvar cancer specifically. But the American Institute for Cancer Research recommends these lifestyle choices (along with smoking cessation) to help prevent cancer overall:

  • Maintain a healthy weight.
  • Be physically active every day.
  • Focus your food choices on whole grains, vegetables, fruit and beans. Try to get the nutrients you need through these foods, not supplements.
  • Eat less “fast food” or other processed foods (especially if they are high in fat, starch or sugar) and less red or processed meat.
  • Drink less alcohol and fewer drinks sweetened with sugar.
  • Protect your skin from the sun.

“Many of the steps you can take to reduce your risk of cancer have the added benefit of helping to reduce your risk of cardiovascular disease, diabetes and possibly even dementia,” said Garnet Anderson, PhD, senior vice president and director of Fred Hutch’s Public Health Sciences Division and holder of the Fred Hutch 40th Anniversary Endowed Chair. “There are plenty of reasons to make these changes.”