Vaginal cancer

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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 risk of developing vaginal cancer increases with age. It occurs most often in women older than 60 years of age.

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.

Known risk factors

There is convincing evidence that the following factors increase your risk for vaginal cancer.

Human papillomavirus (HPV) infection

Many women, especially younger women, who develop vaginal cancer, have an 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) exposure

DES is a synthetic form of estrogen. Between 1940 and 1971, DES was used to help prevent miscarriage in women who had certain problems during pregnancy.

Women whose mothers took DES during their pregnancy have a higher than average risk of developing clear cell adenocarcinoma of the vagina. The risk appears to be greatest in women whose mothers 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.

Because DES has not been given to pregnant women since 1971, there now are fewer women with DES-related vaginal cancer.

Personal history of precancerous conditions

Women who have been diagnosed with vaginal intraepithelial neoplasia (VAIN) or cervical dysplasia have a higher risk of developing vaginal cancer. HPV has been shown to be linked to the development of cervical dysplasia and VAIN.

Personal history of cervical, vulvar or anal cancer

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

Previous radiation therapy

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

Weakened immune system

The immune system can be weakened by immune-suppressing drugs that people take after an organ transplant. These drugs help prevent the body rejecting the organ. It can also be weakened by infection with the human immunodeficiency virus (HIV).

A weakened immune system can lower the body’s defences against infection and disease. It can increase a woman’s risk for HPV infections 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 can develop into vaginal cancer.

Possible risk factors

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


Some studies suggest that smoking may be a risk factor for vaginal cancer. The evidence linking smoking with vaginal cancer isn’t as strong as the evidence linking smoking with cervical cancer. But smoking increases the chance that an HPV infection will not go away on its own. This could help explain why smoking may be a risk factor for vaginal cancer.

Vaginal irritation

Some small studies link vaginal cancer with long-term vaginal irritation from using a pessary (a device to keep the uterus in place). There is not enough research to confirm this link.


A hysterectomy is surgery to remove the uterus, or womb. Some studies link hysterectomy with a higher risk for vaginal cancer. This may be because hysterectomies are associated with other risk factors, such as previous cervical cancer.

Unknown risk factors

It isn’t known whether or not drinking alcohol is linked with vaginal cancer. It may be that researchers can’t show a definite link or that studies have had different results. Further study is needed to see if alcohol is a risk factor for vaginal cancer.

Questions to ask your healthcare team

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


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