There are a number of risk factors that researchers believe may be associated with vaginal cancer. These include:
- Age: Nearly half of all vaginal cancer cases involve women over the age of 70. Only 15 percent of cases are found in women younger than 40.
- HIV infection.
- In utero exposure to diethylstilbestrol (DES): In the 1950s, some women were given the hormonal drug DES to prevent miscarriage. Women who were exposed to DES in the womb, however, have an increased risk of developing vaginal cancer, and some of them develop a rare cancer called clear cell adenocarcinoma. Women who were exposed to DES in the womb—meaning they are over 60 years old now—thus have a better chance of contracting vaginal cancer.
- HPV and abnormal cervical cells: Having contracted the human papilloma virus, a sexually transmitted infection, and having developed abnormal cervical cells or cervical cancer may also increase a woman’s risk of vaginal cancer.
- Smoking: Smoking cigarettes more than doubles a woman’s risk of developing vaginal cancer.
- Alcohol: Studies have shown that alcoholic women may have a higher risk of developing vaginal cancer, and women who abstain from alcohol have a lower chance of developing vaginal cancer.
- Atypical vaginal cells: About 40 percent of women have a condition called vaginal adenosis, in which the vagina has one or more areas where it is lined by glandular cells instead of the normal squamous cells (this occurs in nearly all women exposed to DES in utero). This increases a woman’s risk of developing vaginal cancer, although the disease is still very rare.
- Vaginal irritation: Women with a condition called uterine prolapse—in which the uterus has begun to sag into the vagina or even extend outside the vagina—are often treated with a pessary, a device that keeps the uterus in place. However, some studies have suggested that long-term irritation of the vagina in women wearing a pessary slightly increases a woman’s risk of vaginal cancer, though this association is rare and no studies have directly linked pessaries to vaginal cancer.
- Vaginal intraepithelial neoplasia: In the staging of vaginal cancer, vaginal intraepithelial neoplasia is often referred to as Stage 0 or a precancerous stage, although many women with neoplasia will never develop cancer. In these cases, there are abnormal cells in the vaginal lining, but they have not begun to spread or grow into the deeper tissues of the vagina.