Vulvar Cancer Risk Factors

What increases the risk of developing vulvar cancer?

A risk factor is something that increases the likelihood of developing a disease.

Having one or more risk factors does not mean a person will develop vulvar cancer. Some people diagnosed with vulvar cancer have no known risk factors.

Human papillomavirus (HPV) infection

Persistent infection with high-risk HPV types is a major risk factor for HPV-associated vulvar cancer.

HPV can cause abnormal cellular changes that eventually develop into vulvar precancer or cancer.

HPV-16 is particularly important in vulvar cancer.

Increasing age

Vulvar cancer can occur at any age, but it is more common in older adults.

HPV-independent vulvar cancers are especially associated with older age, although they can occur earlier.

Lichen sclerosus

Lichen sclerosus is a chronic inflammatory skin condition that often affects the vulva.

It can cause:

• White or pale patches of skin

• Persistent itching

• Fragile skin

• Painful tearing

• Changes in vulvar anatomy

People with vulvar lichen sclerosus have an increased risk of developing HPV-independent squamous cell carcinoma.

Most people with lichen sclerosus do not develop vulvar cancer.

Appropriate treatment and follow-up are important.

Vulvar precancer

A history of vulvar high-grade squamous intraepithelial lesions or differentiated VIN increases the risk of invasive vulvar cancer.

These abnormal changes may require treatment and continued monitoring.

Smoking

Smoking increases the risk of HPV-associated vulvar cancer.

Smoking can interfere with immune responses that help the body control HPV infections.

Weakened immune system

People with weakened immune systems may have difficulty clearing HPV infections.

Risk may be increased among people with HIV or those taking certain medications that suppress immune function.

Previous HPV-related cancers or precancers

A history of cervical, vaginal, or anal precancer or cancer may indicate increased risk of HPV-associated disease elsewhere in the anogenital region.

Can vulvar cancer occur without HPV?

Yes.

HPV-independent vulvar cancer is a major subtype of the disease.

This is an important distinction because a negative HPV test does not rule out vulvar cancer.