Causes and risks of vulval cancer

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There are a number of risk factors known to increase the chances of vulval cancer developing:

Age The risk of developing vulval cancer increases with age. About 8 out of 10 women (80%) who are diagnosed with vulval cancer are over the age of 60. Vulval cancer in older women is usually associated with a skin condition called lichen sclerosus. But vulval cancer is becoming increasingly common among younger women, in whom it is often linked to HPV infection.

Vulval skin conditions Women who have non-cancerous skin conditions of the vulva, such as vulval lichen sclerosus and vulval lichen planus| , have a higher risk of developing cancer of the vulva. About 3 to 5 out of every 100 women (3-5%) who have lichen sclerosus go on to develop vulval cancer. It is thought that over a long period of time the inflammation caused by these skin conditions increases the risk of cancer developing in the skin of the vulva.

Human papilloma virus ( HPV |) Infection with this virus is a risk factor for vulval cancer. HPV is a very common infection and is usually passed between people during sex. There are many different types of HPV and each is identified by a number. Some types (particularly 16, 18 and 31) are linked to vulval cancer and pre-cancerous changes called VIN.

Most women with HPV infection don’t have any problems, as their immune system quickly gets rid of the virus. But in a few women, the virus remains and may go on to cause abnormal changes in the skin of the vulva and sometimes vulval cancer.

Vulval intraepithelial neoplasia (VIN| ) This is a pre-cancerous condition that can occur in the skin of the vulva. In some women VIN develops into vulval cancer.


Smoking and alcohol
Researchers have found a link between vulval cancer and smoking. Being a smoker may mean that you are less able to get rid of the HPV infection from your body. It is also possible that the harmful substances in tobacco damage cells in the vulva and so lead to the development of vulval cancer.

One study has shown that women who do not drink alcohol have a lower risk of vulval cancer than women who drink some alcohol. This may be because of lifestyle factors linked to alcohol consumption and the likelihood of HPV infection.

Smoking and alcohol

Researchers have found a link between vulval cancer and smoking. Being a smoker may mean that you are less able to get rid of the HPV infection from your body. It is also possible that the harmful substances in tobacco damage cells in the vulva and so lead to the development of vulval cancer.

One study has shown that women who do not drink alcohol have a lower risk of vulval cancer than women who drink some alcohol. This may be because of lifestyle factors linked to alcohol consumption and the likelihood of HPV infection.


Vulval intraepithelial neoplasia (VIN) means there are precancerous changes in the top layer of the skin (epithelium) covering the vulva. VIN is often divided into 3 categories - VIN1, VIN2 and VIN3. These categories are also called mild, moderate or severe dysplasia. Dysplasia means abnormal cells. Many women with VIN have HPV infection.

The most common symptom of VIN is a lasting itch that doesn't go away. Areas of skin affected by VIN can look thickened and swollen, and have red, white or dark coloured patches. VIN is not cancer, but there is a risk that it may go on to develop into vulval cancer, usually over many years. Although most cases of VIN will not develop into cancer, it is not possible to tell which will and which won’t. So everyone with this condition should have treatment, or at least close monitoring of their condition by a doctor.

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