Risks and causes of vulval cancer

We don’t know what causes all vulval cancers. But there are some risk factors that can increase your risk of developing it. These include being older and having infections with certain viruses.

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.

Getting older

As with most cancers, vulval cancer is more common as you get older. On average each year more than 40 out of 100 (more than 40%) new cases are in women aged 75 and over.

Vulval cancers can also occur in young women but this is rare. 

Human papilloma virus (HPV) infection

The human papilloma virus (HPV) can infect the skin in different parts of the body, including the vulva. HPV can pass from one person to another by skin to skin contact, usually during sexual activity including oral sex.

Researchers think that around 80 out of 100 people will be infected with HPV at some time during their lives. So it is a very common infection. In most people, it doesn't cause any problems and goes away without treatment. But people infected with high risk HPV types are more likely to go on to develop cancer, including vulval cancer.

Almost 70 out of every 100 vulval cancers are caused by HPV infections. 

There are many different types of HPV and some are more likely to cause vulval cancer than others. The most common types of HPV related to vulval cancer are:

  • HPV type 16
  • HPV type 33
  • HPV type 18

The HPV vaccine helps to protect against HPV infections. All children aged between 11 and 13 in the UK can get the HPV vaccine. It is also offered to some people in older age groups too.

Weakened immune system

Your risk of developing vulval cancer is higher if you have a weakened immune system Open a glossary item. This includes people with HIV (human immunodeficiency virus). 

HIV is the virus that causes AIDS (acquired immune deficiency syndrome). This virus weakens your immune system and so you are more likely to pick up other infections, such as HPV. 

The risk is also higher in people who have had an organ transplant. This is because you have to take drugs to suppress your immune system after a transplant. This is to stop the body from rejecting the transplanted organ. 

Lichen sclerosus

Lichen sclerosus is a long term vulval skin condition that causes itching and sometimes pain in the vulval area. This usually affects women over the age of 60. Women with lichen sclerosus may develop a condition called differentiated vulval intraepithelial neoplasia (dVIN). 

Without treatment, dVIN can turn into vulval cancer. 

Vulval intraepithelial neoplasia (VIN)

VIN is a skin condition of the vulva. It means that abnormal cells have developed in the surface layers of the skin covering the vulva. It is not cancer but could turn into vulval cancer. This may take many years.

Other cancers

Some studies have shown that having had other types of cancer can also increase the risk of vulval cancer. This includes:

  • cervical cancer
  • pre cancerous changes in the cells of the cervix (CIN)

This is because both cancers have similar risk factors such as HPV.

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 risk

There are ways you can reduce your risk of cancer.

Last reviewed: 
09 Nov 2022
Next review due: 
09 Nov 2025
  • British Gynaecological Cancer Society (BGCS) vulval cancer guidelines: recommendations for practice
    British Gynaecological Cancer Society, 2020

  • Cancer of the vulva: 2021 update (FIGO cancer report 2021)
    A Olawaiye, M Cuello and L Rogers
    International Journal of Gynaecology & Obstetrics, 2021. Vol 155, Issue S1, Pages 7-18

  • Cancer Incidence from Cancer Intelligence Statistical Information Team at Cancer Research UK  (2016 - 2018 UK average) 
    Last checked November 2022

  • List of classifications by cancer sites with sufficient or limited evidence in humans, IARC monographs volumes 1-132
    International Agency for Research on Cancer, Last checked Nov 2022

  • 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. Vol 118, Issue 8. Pages 1130-1141

  • 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 risk or cause you are interested in.

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