Risk factors for vaginal cancer

A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. But sometimes vaginal cancer develops in women who don’t have any of the risk factors described below.

The chance of developing vaginal cancer increases with age. It happens most often in women 60 years of age and older.

Vaginal intraepithelial neoplasia (VAIN) is a precancerous condition of the vagina. It isn’t cancer, but it can sometimes become vaginal cancer if it isn’t treated. Some of the risk factors for vaginal cancer may also cause VAIN. Find out more about precancerous conditions of the vagina.

Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.

Human papillomavirus (HPV)

Many women who develop vaginal cancer, especially younger women, have a human papillomavirus (HPV) infection. But having an HPV infection doesn’t mean that you will develop vaginal cancer. Many different types of HPV can infect the vagina. Only some of them cause abnormal changes to cells that may turn into cancer.

Find out more about human papillomavirus (HPV).

Diethystilbestrol (DES)

Diethylstilbestrol (DES) is a form of estrogen. It was used between 1940 and 1971 to help prevent miscarriage in women who had certain problems during pregnancy.

Daughters of women who took DES during their pregnancy have a higher than average risk of developing a type of vaginal cancer called clear cell adenocarcinoma. The risk appears to be greatest when the women took DES during the first 16 weeks of pregnancy. The average age of diagnosis for DES-related vaginal cancer is much younger than for other vaginal cancers. DES-related vaginal cancer doesn’t happen much anymore because DES has not been given to pregnant women for over 40 years.

History of precancerous conditions of the cervix

Women who have been diagnosed with a high-grade precancerous condition of the cervix have a higher risk of developing vaginal cancer. HPV is linked to the development of precancerous conditions of the cervix.

Find out more about precancerous conditions of the cervix.

History of cervical, vulvar or anal cancer

Women who have been diagnosed with cancer of the cervix, vulva or anus have a higher risk of developing vaginal cancer. This may be due to the fact that these cancers have similar risk factors, such as HPV infection.

Radiation therapy for cervical cancer

Women who had radiation therapy to treat cervical cancer have a higher risk of developing vaginal cancer.

Weakened immune system

Women with a weakened immune system (immunosuppression) have a higher risk of developing vaginal cancer. This includes people with a human immunodeficiency virus (HIV) infection and those who have had an organ transplant and must take medicines to suppress their immune system.

A weakened immune system can increase a woman’s risk for HPV infection and increase the chance that the infection won’t go away. When the immune system is weakened, there is a greater chance that precancerous changes to cells in the vagina will develop into vaginal cancer.

Possible risk factors

The following factors have been linked with vaginal cancer, but there is not enough evidence to show for sure that they are risk factors. More research is needed to clarify the role of these factors for vaginal cancer.

  • smoking tobacco
  • long-term (chronic) vaginal irritation
  • having a hysterectomy for cervical cancer or precancerous conditions of the cervix

Questions to ask your healthcare team

To make the decisions that are right for you, ask your healthcare team questions about risks.

Expert review and references

  • Akino N, Wada-Hiraike O, Matsumoto Y, et al . Vaginal cancer possibly caused by pessary and immunocompromised condition: multiple risk factors may influence vaginal cancer development. Journal of Obstetrics and Gynaecology Research. 2016.
  • Canadian Cancer Society's Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2016. Toronto, ON: Canadian Cancer Society; 2016: https://cancer.ca/en/research/cancer-statistics.
  • Daling JR, Madeleine MM, Schwartz SM, et al . A population-based study of squamous cell vaginal cancer: HPV and cofactors. Gynecologic Oncology. 2002.
  • Ebisch RMF, Rutten DWE, IntHout J, et al . Long-lasting increased risk of human papillomavirus-related carcinomas and premalignancies after cervical intraepithelial neoplasia grade 3: a population-based cohort study. Journal of Clinical Oncology. 2017: http://jco.ascopubs.org/.
  • International Agency for Research on Cancer (IARC) . Volume 90: Human Papillomaviruses . 2007 : http://monographs.iarc.fr/ENG/Monographs/vol90/mono90.pdf.
  • International Agency for Research on Cancer (IARC). Volume 75: Ionizing Radiation Part 1: X- and Gamma (y)-Radiation, and Neutrons. 2000: http://monographs.iarc.fr/ENG/Monographs/vol75/mono75.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100A: Pharmaceuticals - A Review of Human Carcinogens. 2012: http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A.pdf.
  • Klopp AH, Eifel PJ, Berek JS, Konstantinopoulos PA . Cancer of the cervix, vagina and vulva. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 72:1013-1047.
  • Li Z, Barron S, Hong W, Karunamurthy A, Zhao C . Surveillance for recurrent cancers and vaginal epithelial lesions in patients with invasive cervical cancer after hysterectomy: are vaginal cytology and high-risk human papillomavirus testing useful. American Journal of Clinical Pathology. 2013: https://academic.oup.com/ajcp/article/140/5/708/1767054.
  • Madeleine MM, Daling JR . Cancers of the vulva and vagina. Schottenfeld D, Fraumeni JF Jr (eds.). Cancer Epidemiology and Prevention. 3rd ed. New York: Oxford University Press; 2006: 55:1068-1074.
  • Madeleine MM, Johnson LG . Vulvar and vaginal cancers. Thun MJ (ed.). Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. 4th ed. New York, NY: Oxford University Press; 2018: 49:947-951.
  • Madsen BS, Jensen HL, van den Brule AJ, Wohlfahrt J, Frisch M . Risk factors for invasive squamous cell carcinoma of the vulva and vagina - population-based case-control study in Denmark. International Journal of Cancer. 2008: https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.23446.
  • National Toxicology Program . 14th Report on Carcinogens . Department of Health and Human Services ; 2016 .
  • Sand FL, Munk C, Jensen SM, Svahn MF, Frederiksen K, Kjaer SK . Long-term risk for noncervical anogenital cancer in women with previously diagnosed high-grade cervical intraepithelial neoplasia: a Danish nationwide cohort study. Cancer Epidemiology, Biomarkers and Prevention. 2016: http://cebp.aacrjournals.org/content/25/7/1090.long.

Reducing your risk for vaginal cancer

Ways of reducing your risk for vaginal cancer include reducing exposure to HPV. Learn how to lower your risk of developing vaginal cancer.