Risks and causes of vaginal cancer

We don’t know what causes most vaginal cancers. But there are some factors that may increase your risk of developing it. These include being older or having certain infections.

What is a risk factor?

Anything that can increase your risk of getting a disease is called a risk factor.

Different cancers have different risk factors.­ Having one or more of these risk factors doesn't mean you will definitely get that cancer.

Age

Age increases the risk of developing vaginal cancer. As vaginal cancer is rare, the increased risk is still very small.

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

Human papilloma virus

Human papilloma virus (HPV) is a common infection. It is passed from one person to another through close skin to skin contact, usually during sexual activity.

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 and will never know they had it. It’s only when the infection won't clear up that there might be a problem.

How can HPV cause cancer?

There are many different types of HPV. People infected with high risk HPV for a long time are more likely to go on to develop cancer. 

Cervical cancer is the main type of cancer linked to HPV. Other types of cancer, including vaginal cancer are also caused by HPV.

HPV is present in:
•    more than 9 out of 10 (more than 90%) vaginal cancers
•    more than 8 out of 10 women (more than 80%) who have pre cancerous changes in the vagina (VAIN)

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

It’s important to remember that most people infected with HPV don’t develop cancer of the vagina. So other factors are also involved. 

HPV vaccine

There is now a vaccine that can protect against certain types of high risk HPV. Doctors think that in the future, we will see a fall in vaginal cancer rates. This will take some years to show up because vaginal cancer can take a long time to develop.

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. Some of these changes could become cancerous if not treated.

Cancer of the cervix or pre cancerous cell changes

Cervical cancer or pre cancerous changes in your cervical cells may also increase the risk of developing vaginal cancer. Pre cancerous cervical cell changes are also called cervical dysplasia or cervical intraepithelial neoplasia (CIN).

HIV infection

HIV or AIDS may increase the 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.

Weakened immune system

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

Lupus increases the risk of vaginal cancer. This may be because people with lupus are more at risk of HPV as their immune systems aren’t functioning well. They may also be taking medicines to dampen down their immune systems (immunosuppressants).

A drug called diethylstilbestrol (DES)

Diethylstilbestrol (DES) is a drug that doctors used to give to pregnant women to stop them from 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 12 weeks of pregnancy are more at risk of getting a type of vaginal cancer called clear cell adenocarcinoma. This usually happens in their late teens or twenties, but cases have also been reported in women in their early 40s. 

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

Smoking

Smoking tobacco might increase your risk of getting vaginal cancer. It is never too late to stop smoking but the sooner you stop the better.

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.

Reducing your cancer risk

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

Last reviewed: 
17 May 2022
Next review due: 
17 May 2025
  • Cancer of the vagina

    FIGO cancer report

    T Adams and M Cuello

    International Journal of Gynaecology and Obstetrics, 2018

  • Cancer: Principles and Practice of Oncology (11th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Wolters Kluwer, 2019

  • The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015

    K Brown and others 

    British Journal of Cancer, 2018. Volume 118, Issue 8, pages 1130–1141

  • The risks of cancer development in systemic lupus erythematosus (SLE) patients: a systematic review and meta-analysis

    L Song and others

    Arthritis Research & Therapy, 2020 Volume 20, Article number: 270

  • The Use of Both Therapeutic and Prophylactic Vaccines in the Therapy of Papillomavirus Disease

    A Garbuglia and others

    Frontiers in immunology, 2020. Volume 18, Issue 188

  •  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.

Related links