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Risks and causes

We don’t know what causes most vaginal cancers. But there are some factors that may increase your risk of developing it.

Having any of these risk factors does not mean that you will definitely develop cancer.

As women get older, their risk of vaginal cancer increases. As vaginal cancer is very rare, the increased risk is still very small.

Almost 40 out of every 100 cases (40%) occur in women aged 75 and over. Vaginal cancer is very rare in women younger than 40.

Human papilloma virus (HPV) is a common infection that is passed from one person to another by sexual contact.

Most people in the UK are infected with the HPV virus at some time during their lifetime. For most people the virus causes no harm and goes away without treatment. It’s only when the infection won't clear up that there might be a problem.

Most women infected with HPV won’t develop vaginal cancer. HPV is present in:

  • almost three quarters of women who have vaginal cancer (75%)
  • more than 90 out of 100 women (90%) who have pre cancerous changes in the vagina (VAIN)

There are many different types of HPV.

HPV types 6 and 11 can infect the female and male genital organs and the anal area, causing visible genital warts. Women who have had genital warts have an increased risk of developing pre cancerous cell changes (VAIN) and some may develop vaginal cancer. 

Women with HPV types 16, 18 and 31, as well as some others, have a higher risk of developing genital and anal cancers.

The type of HPV most strongly linked to vaginal cancer is HPV 16. This type can cause changes in the cells covering the vagina. The changes make the cells more likely to become cancerous in time. But this can take years.

Most women infected with this virus don’t develop cancer of the vagina. So other factors must also be involved. 

Having regular cervical screening tests may help to pick up VAIN or very early vaginal cancer.

Girls who have the HPV vaccine before they’re exposed to the HPV virus have a lower risk of developing VAIN. But the risk of high-grade VAIN is not reduced in girls who receive the HPV vaccine after they have been exposed to HPV. 

A condition called VAIN can mean you are more at risk of getting vaginal cancer. VAIN stands for vaginal intraepithelial neoplasia. It means there are changes to the cells in the inner lining of the vagina. Some of these changes could become cancerous if not treated.

If you’ve had cervical cancer or pre cancerous changes in your cervical cells, you have an increased risk of developing vaginal cancer. Pre cancerous cervical cell changes are also called cervical dysplasia or cervical intraepithelial neoplasia (CIN).

Women with HIV or AIDS may have an increased risk of vaginal cancer as well as other cancers in the genital or anal area. This may be because HIV and AIDS lower immunity so the body is less able to overcome HPV infection. Most women with vaginal cancer don’t have HIV or AIDS.

Systemic lupus erythematosus is a long term (chronic) illness which affects the immune system. The immune system starts to attack healthy cells, tissues and organs.

Women with lupus have an increased risk of vaginal cancer. This may be because they are more at risk of HPV as their immune systems aren’t functioning properly. They may also be taking medicines to dampen down their immune systems (immunosuppressants).

Diethylstilbestrol (DES) is a drug that doctors used to give to pregnant women to stop them having a miscarriage. DES was only used between 1945 and 1970 and researchers are still gathering information about its effects.

Daughters of women who took DES during their pregnancy (particularly during the first trimester) are more at risk of getting a type of vaginal cancer called clear cell adenocarcinoma.

It seems daughters of women who took DES are most likely to develop vaginal cancer in their late teens or twenties, but cases have also been reported in women in their early 40's. 

Clear cell adenocarcinoma is a very rare type of cancer. Only about 2 in 1,000 (0.02%) women with a mother who took DES go on to develop vaginal or cervical cancer. DES hasn't been used for over 40 years now, so it’s becoming less common as a risk factor.

A large American study has shown that women who have had womb cancer have a 3 times higher risk of vaginal cancer than women in the general population.

Women who have had radiotherapy for their womb cancer have a higher risk compared to those who haven't had radiotherapy.

There may be a link between cancer of the vagina and smoking. But there have only been a small number of studies looking into this, so there is not enough evidence to support this link yet.

Other possible causes

Stories about potential causes are often in the media and it isn’t always clear which ideas are supported by evidence. There might be things you have heard of that we haven’t included here. This is because either there is no evidence about them or it is less clear.

More information about vaginal cancer risks and causes

Reducing your cancer risk

There are ways you can reduce your overall risk of cancer.

Last reviewed: 
01 Sep 2015
  • Preventable exposures associated with human cancers
    VJ Cogliano and others
    Journal of the National Cancer Institute, 2011. Volume 103, Issue 24

  • Large contribution of human papillomavirus in vaginal neoplastic lesions: a worldwide study in 597 samples
    L Alemany and others
    European Journal of Cancer, 2014. Volume 50, Issue 16

  • Genital warts and risk of cancer: a Danish study of nearly 50 000 patients with genital warts
    M Blomberg and others
    Journal of Infectious Diseases, 2012. Volume 205, Issue 10

  • Second neoplasms in survivors of endometrial cancer: impact of radiation therapy
    S Kumar and others
    Gynecologic Oncology, 2009. Volume 113, Issue 2

  • Treatment for cancer (6th edition)
    P Price and K Sikora (editors)
    CRC Press, 2015

  •  The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in.

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