Vulval cancer

Cancer of the vulva is when the cells in the vulva change and grow in an abnormal way. A group of these cancer cells can form a tumour. It can develop in any of the external sex organs that make up the vulva, but it’s most commonly seen in the outer lips (labia majora) and inner lips (labia minora). It occurs less commonly in the clitoris.

Vulval cancer is a slow-growing cancer and may develop over years. There are different types of vulval cancer, some of which are very rare.

Cancer of the vulva is a rare cancer. In Ireland, there are about 70 cases a year. The risk of vulval cancer increases with age, but it can happen at any age.

The vulva refers to the external female sex organs.

The vulva is made up of:

• Two outer lips (labia majora)
• Two inner lips (labia minora)
• The clitoris at the front of the vulva. It helps you reach sexual climax
• The urethral opening – the urethra is the tube that drains urine
• The vaginal opening
• The perineum – the area of skin between the vulva and the anus (back passage

The cause of vulval cancer is unknown. But there are certain things called risk factors that can increase your chance of developing the disease. 

Risk factors

• HPV: Around 1 in 3 vulval cancer cases are linked to the HPV virus. It can also cause vulval intraepithelial neoplasia (VIN). VIN is cell changes in the skin of the vulva. VIN is not a cancer but is precancerous and if left untreated can lead to vulval cancer. About 8 in 10 cases of VIN are linked to HPV infection.
• VIN: Precancerous changes in the top layer of skin covering the vulva, which can sometimes develop into vulva cancer over a number of years. If you have VIN, you may have some treatment to reduce your risk of developing vulval cancer. For example, regular monitoring (surveillance) or laser treatment or surgery to remove the abnormal area. 
• Age: It is more common in women over the age of 60.
• Smoking: Smoking may also increase your risk of developing both VIN and vulval cancer. The chemicals in cigarettes can affect how you fight infection in the vulva.
• Benign conditions: If you have certain skin conditions for a long time, you have a higher risk of developing vulval cancer. These conditions include vulval lichen sclerosis and vulval lichen planus. Both can cause long-term irritation of the skin in the vulval area. Paget’s disease of the vulva in post-menopausal woman can also increase your risk but only in a small number of women.

The HPV vaccine protects against HPV types 16 and 18, which increase the risk of vulval cancer.

Having a risk factor doesn’t mean you will get cancer. Sometimes people with no risk factors get cancer. If you’re worried, talk to your GP or talk to one of our cancer nurses. Call our Support Line on 1800 200 700 or visit a Daffodil Centre.