Vaginal cancer causes and risk factors

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on June 7, 2022.

Vaginal cancer is considered one of the rarer types of cancer affecting women, representing 1 percent to 2 percent of all cancers that develop in the female genital tract.

What causes vaginal cancer?

While it may not be possible to pinpoint the exact cause of a women's vaginal cancer, about 75 percent of vaginal cancer diagnoses are linked to infection with human papillomavirus (HPV).

Vaginal cancer risk factors

Certain factors may increase a woman's risk for developing vaginal cancer, such as age, smoking and previous conditions.

Common risk factors for vaginal cancer include those listed below.

Age: The risk for developing vaginal cancer increases with age. The average age at diagnosis is 67.

Alcohol: Some studies have suggested that drinking alcohol increases a woman’s risk for developing vaginal cancer. However, it's not clear if this is entirely caused by alcohol, or whether it may be related to associated risk factors such as smoking or HPV infection.

Cervical cancer: A previous diagnosis of cervical cancer or cervical dysplasia (a precancerous condition) may increase the risk for developing vaginal cancer. This may be related to shared risk factors, such as HPV infection and smoking.

Diethylstilbestrol (DES): Women whose mothers were exposed to DES, a hormonal drug that was used from 1940 to 1971 to prevent miscarriage, are at increased risk for developing a specific subtype of vaginal cancer called clear cell adenocarcinoma. The risk is highest in daughters of women who took this drug during the first 16 weeks of pregnancy. However, the risk is low, and only 1 out of 1,000 women whose mothers took the drug will develop this type of cancer. These women are also more likely to develop precancerous high-grade vaginal dysplasia, as well as a condition known as vaginal adenosis.

Human papillomavirus (HPV): HPV is a group of more than 100 viruses, some of which are sexually transmitted and may increase a person’s risk for developing other cancers of the reproductive system. Some of the more common HPV strains may cause warts (papillomas), while other types of HPV infections may have no visible symptoms. HPV types 16 and 18 have been most strongly linked to cancer. Women under age 30 are at greatest risk of HPV infection. Protection against HPV may help many younger women reduce their vaginal cancer risk, and two HPV vaccines are currently approved for use in the United States.

Smoking: A woman who smokes has at least double the risk of developing vaginal cancer as a woman who does not smoke.

Vaginal adenosis: This non-cancerous condition is characterized by glandular cells lining areas of the vagina instead of flat squamous epithelial cells. Approximately 40 percent of women who have begun menstruating have this condition, and nearly all women whose mothers took DES will develop it. Women with adenosis have a small but increased risk for developing vaginal cancer, and regular screening and follow-up is recommended.

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Show references
  • American Cancer Society (2021, March 18). Key Statistics for Vaginal Cancer.
  • National Cancer Institute (2023, April 4). HPV and Cancer.
  • Ovarian Cancer Research Alliance (undated). Vaginal Cancer.
  • American Cancer Society (2018, March 19). Risk Factors for Vaginal Cancer.