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Risks and causes of vaginal cancer

Vaginal cancer is rare in the UK. We don’t know the exact causes of vaginal cancer. But researchers have identified several risk factors. 

Age

More than 7 out of every 10 vaginal cancers (70%) are in women over 60.

Human papilloma virus infection

Infection with human papilloma virus infection (HPV) type 16 increases the risk of vaginal cancer. More than two thirds of women with vaginal cancer have had human papilloma virus (HPV).

Other medical conditions

You have an increased risk of vaginal cancer if you have had precancerous changes in either the vagina (vaginal intraepithelial neoplasia – VAIN) or cervix (cervical intraepithelial neoplasia – CIN). Many women with precancerous changes have HPV infection. Your vaginal cancer risk is also increased if you've had cervical cancer.

Women who have HIV or AIDS are more at risk of developing vaginal cancer. But most women who have vaginal cancer do not have HIV or AIDS. Women with an auto immune condition called systemic lupus erythematosus have a higher risk of vaginal cancer than other women in the population.

Other factors

Other factors that may increase the risk of vaginal cancer are organ transplants, womb cancer treatment (especially radiotherapy), smoking, and a drug called diethylstilbestrol (DES). 

 

CR PDF Icon You can view and print the quick guides for all the pages in the about vaginal cancer section.

 

 

What a risk factor is

A risk factor is anything that can increase your chance of developing a disease. Different cancers have different risk factors. There are some factors that may increase your risk of vaginal cancer.

Remember that having one or more risk factors does not mean that you will definitely get vaginal cancer. Many people with one or more risk factors never get it. And sometimes people with none of these risk factors develop vaginal cancer. Risk factors are only a guide to what may increase risk.

 

How common vaginal cancer is

We don’t know the exact causes of vaginal cancer. It is a rare cancer with just under 260 new cases diagnosed in the UK each year. That is less than 1 out of every 600 cancers diagnosed in women.

Cancer starting in another place in the body such as cancer of the cervix, womb cancer or bowel cancer can spread to the vagina. This is not the same as cancer starting in the vagina. Cancer starting in the vagina is known as primary vaginal cancer. Cancer that has spread from another place in the body is called secondary cancer.

Because vaginal cancer is such a rare type of cancer, it is very difficult to carry out research involving large enough numbers of women to give any reliable results. But researchers have managed to identify several risk factors.

 

Age

As women get older their risk of vaginal cancer increases. But because vaginal cancer is very rare, the increased risk is still very small. Cancer of the vagina is more common in older women. More than 7 out of every 10 cases (70%) occur in women aged 60 and over. It is an extremely rare type of cancer in women younger than 40.

 

Changes in the cells lining the vagina

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. These changes are not enough to make the cells cancerous. But they could become cancerous if not treated. There is information about vaginal intraepithelial neoplasia (VAIN) in this section.

 

Human papilloma virus infection

Human papilloma virus (HPV) is a common infection and is passed from one person to another by sexual contact. Around 8 out of 10 people (80%) 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 is only when the infection won't clear up that sometimes there is a problem. But most women infected with HPV don’t go on to develop vaginal cancer.

HPV is present in two thirds of women who have vaginal cancer (66%) and more than 9 out of 10 women who have precancerous changes in the vagina (VAIN). There are many different types of human papilloma virus (HPV). HPV types 6 and 11 can infect the female and male genital organs and the anal area, causing visible genital warts. Women with these types of the virus have an increased risk of developing precancerous 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. But the type of HPV most strongly linked to vaginal cancer is HPV 16. This type of HPV 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 do not develop cancer of the vagina. So other factors must also be needed. 

Although not designed to do so, having regular cervical screening tests may help to pick up vaginal cancer in its very early stages or in its precancerous stage (VAIN).

 

CIN or cancer of the cervix

If you have had cervical cancer or precancerous changes in your cervical cells, you have an increased risk of developing vaginal cancer. Precancerous cervical cell changes are also called cervical dysplasia or CIN (which stands for cervical intraepithelial neoplasia).

 

Womb cancer treatment

A large American study has shown that women who have had womb cancer have a risk of vaginal cancer that is 3 times higher than women in the general population. In women who have had radiotherapy for their womb cancer the risk is higher compared to women who did not have radiotherapy.

 

Smoking

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 and most studies show no increase in risk amongst smokers. A recent study of women with HPV infection showed that women who smoked were more likely to develop advanced VAIN than non smokers.

 

Systemic lupus erythematosus

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

Women with systemic lupus erythematosus have an increased risk of vaginal cancer. This may be due to them being more at risk of HPV as their immune systems are not functioning properly. They may also be on immunosuppressant medication (drugs to dampen down the body's immune system). 

 

HIV infection

Women with HIV or AIDS may have an increased risk of vaginal cancers, as well as other cancers in the genital or anal area. This may be because HIV and AIDS lower immunity so that the body is less able to overcome HPV infection. But most women who have vaginal cancer do not have HIV or AIDS.

 

Organ transplant

Women who have had organ transplants (such as kidney or heart transplants) have a risk of vaginal cancer that is more than 20 times higher than other women.

 

A drug called diethylstilbestrol

Diethylstilbestrol is also called DES. It is a drug that doctors sometimes gave to pregnant women in the past, to stop them having a miscarriage. DES was only used between 1945 and 1970 and researchers are still gathering information about its effects. The 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 and only about 2 in 1,000 women with a mother who took DES will go on to develop vaginal or cervical cancer. DES hasn't been used for over 35 years now, so it is becoming less important as a risk factor.

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Updated: 15 January 2014