Risks for vaginal cancer

Last medical review:

Some things can affect your risk, or chance, of developing cancer. Certain behaviours, substances or conditions can increase or decrease the risk. Most cancers are the result of many risks. But sometimes cancer develops in people who don't have any risks.

The risk of developing vaginal cancer increases with age. It occurs more often in people older than 60 years of age.

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

The following can increase your risk for vaginal cancer. Some of these risks can't be changed. But in other cases, there are things you can do to lower your risk.

Infection with human papillomavirus (HPV)

Exposure to diethylstilbestrol (DES) before birth

History of squamous intraepithelial lesion (SIL)

Weak immune system

History of anal, cervical or vulvar cancer

Radiation therapy to the pelvis

Infection with human papillomavirus (HPV)

Human papillomavirus (HPV) is a group of more than 100 related viruses. HPV can cause warts (called papillomas) on different parts of the body, including the genitals. HPV infections are very common because the virus is easily passed by skin-to-skin contact with any infected area of the body. It is mainly spread through sexual contact, including oral sex.

Many people who develop vaginal cancer have an HPV infection. But having an HPV infection doesn't mean that you will develop vaginal cancer.

Learn more about human papillomavirus (HPV) and how to reduce your risk of HPV.

Exposure to diethystilbestrol (DES) before birth

Diethylstilbestrol (DES) is a form of synthetic estrogen. It was used between 1940 and 1971 to help prevent miscarriage and early labour.

People born to women who took DES during their pregnancy have a higher risk for a type of vaginal cancer called clear cell adenocarcinoma. When this type of vaginal cancer is related to DES exposure, it is more likely to develop at a younger age than other types of vaginal cancer.

History of squamous intraepithelial lesion (SIL)

Squamous intraepithelial lesion (SIL) is also called cervical intraepithelial neoplasia (CIN). It is a precancerous condition of the cervix. If you have had SIL, you have a higher risk for vaginal cancer. The risk is greater for people with a history of high-grade SIL (HSIL).

Weak immune system

Having a weak immune system (immunosuppression) increases your risk for vaginal cancer. You may have a weak immune system for different reasons, including if you have HIV( AIDS) or if you have had an organ transplant and must take medicines to suppress your immune system.

History of anal, cervical or vulvar cancer

People who have a personal or family history of any cancer of the anus or genitals have a higher risk for vaginal cancer. This includes anal, cervical and vulvar cancer. These cancers share some of the same risk factors as vaginal cancer, such as HPV infection.

Radiation therapy to the pelvis

People who received radiation therapy to the pelvis to treat cancer or another health condition have a higher risk for vaginal cancer.

Possible risk factors

The following have been linked with vaginal cancer, but more research is needed to know for sure that they are risks:

  • smoking tobacco
  • using a vaginal pessary (a medical device used to help support organs in the pelvis or control urine leakage)
  • having a hysterectomy for cervical cancer or precancerous conditions of the cervix

Understanding your cancer risk

To make the decisions that are right for you, ask your doctor questions about risks. Learn how cancer can be prevented and what you can do to reduce your risk.

Expert review and references

  • Canadian Cancer Society | Société canadienne du cancer
  • Alfonzo E, Holmberg E, Sparen P, Milson I, Stander B. Risk of vaginal cancer among hysterectomized women with cervical intraepithelial neoplasia: A population based national cohort study. British Journal of Obstetrics and Gynecology. 2020: 127(4):448–454.
  • Almeida GV, Bernardino M, Jorge AF, Luís C, Charepe N. Risk of progression to vaginal cancer after successful treatment of high-grade cervical intraepithelial neoplasia: A long-term cohort study in a single institution. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2023: 12(5):1212–1216.
  • Baval SK, Biswas P, Kaium MA, Islam MA, Dey D, Saber M, et al.. A comprehensive discussion in vaginal cancer based on mechanisms, treatments, risk factors, and prevention. Frontiers in Oncology. 2022: 12:883805.
  • Cao O, Wu D, Xu Y. Vaginal intraepithelial neoplasia in patients after total hysterectomy. Current Problems in Cancer. 2022: 45(3):100687.
  • Alberta Health Services. MyHealth Alberta.ca: Diethylstilbestrol (DES). Government of Alberta; 2023. https://myhealth.alberta.ca/.
  • Huang K, Xu L, Jia M, Liu W, Wang S, Han J, et al.. Second primary malignancies in cervical cancer and endometrial cancer survivors: A population based analysis. Aging. 2022: 14(9):3836–3855.
  • Hussain SK, Sundquist J, Hemminki K. Familial clustering of cancer at human papillomavirus-associated sites according to the Swedish Family-Cancer Database. International Journal of Cancer. 2008: 122(8):1873–1878.
  • 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 100A: Pharmaceuticals - A Review of Human Carcinogens. 2012. http://monographs.iarc.fr/ENG/Monographs/vol100A/mono100A.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100B: Biological agents: A Review of Human Carcinogens. 2012. http://monographs.iarc.fr/ENG/Monographs/vol100B/mono100B.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100D: Radiation: A Review of Human Carcinogens. 2011. http://monographs.iarc.fr/ENG/Monographs/vol100D/mono100D.pdf.
  • International Agency for Research on Cancer (IARC). Volume 100E: Personal Habits and Indoor Combustions. 2012. http://monographs.iarc.fr/ENG/Monographs/vol100E/mono100E.pdf.
  • Kalliala I, Athanasiou A, Veroniki AA, Salanti G, Efthimiou O, Raftis N, et al.. Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature. Annals of Oncology. 2023: 31(2):213–217.
  • Kulkarni A, Dogra N, Zigras T. Innovations in the management of vaginal cancer. Current Oncology. 2022: 29(5):3082–3092.
  • Lekoane KMB, Kuupiel D, Mashamba-Thompson TP, Ginindzi TG. The interplay of HIV and human papillomavirus-related cancers in sub-saharan Africa: scoping review. Systematic Reviews. 2020: 9(1):88.
  • Madeleine MM, Johnson LG. Vulvar and Vaginal Cancers. Thun MJ, Linet MS, Cerhan JR, Haiman CA Schottenfeld D, eds.. Schottenfeld and Fraumeni Cancer Epidemiology and Prevention. 4th ed. New York, NY: Oxford University Press; 2018: If using e-book use the following: Kindle version, [chapter 49] https://read.amazon.ca/?asin=B0777JYQQC&language=en-CA.
  • Matsuo K, Blake EA, Machida H, Mandelbaum RS, Roman LD, Wright JD. Incidences and risk factors of metachronous vulvar, vaginal, and anal cancers after cervical cancer diagnosis. Gynecologic Oncology. 2018: 150(3):501–508.
  • National Toxicology Program. Report on Carcinogens. 15 ed. Research Triangle Park, NC: US Department of Health and Human Services, Public Health Service; 2021. https://ntp.niehs.nih.gov/whatwestudy/assessments/cancer/roc/index.html.
  • Pang L, Li L, Zhu L, Lang J, Bi Y. Malignant transformation of vaginal adenosis to clear cell carcinoma without prenatal diethylstilbestrol exposure: A case report and literature review. BMC Cancer. 2019: 19(1):798.
  • Statistics Canada. Table: 13-10-0111-01: Number and rates of new cases of primary cancer, by cancer type, age group and sex. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310011101. June 19, 2024.
  • Stuebs FA, Dietl Ak, Koch MC, Adler W, Geppert CI, Hartman A, et al.. Cytology and HPV co-testing for detection of vaginal intraepithelial neoplasia: a retrospective study. Cancers. 2023: 15:4633.
  • Suk R, Mahale P, Sonaware K, Sikora AG, Chhatwal J, Schmeler KM, et al.. Trends in risks for second primary cancers associated with index human papillomavirus-associated cancers. JAMA Network Open. 2018: 1(5):e181999.
  • Wamakima BW, McKinney S, Bookman L, Gompers A, Hacker MR, Farid H. Post-menopausal vaginal and cervical cancer risk related to in utero diethylstilbestrol exposure. Journal of Lower Genital Tract Disease. 2023: 21(1):35–39.
  • Xu L, Selk A, garland SM, Bogliatto F, Kyrgiou M, Weyers S, et al.. Prophylatic vaccination against human papillomaviruses to prevent vulval and vaginal cancer and their precursors. Expert Review of Vaccines. 2019: 18(11):1157–1166.

Medical disclaimer

The information that the Canadian Cancer Society provides does not replace your relationship with your doctor. The information is for your general use, so be sure to talk to a qualified healthcare professional before making medical decisions or if you have questions about your health.

We do our best to make sure that the information we provide is accurate and reliable but cannot guarantee that it is error-free or complete.

The Canadian Cancer Society is not responsible for the quality of the information or services provided by other organizations and mentioned on cancer.ca, nor do we endorse any service, product, treatment or therapy.


1-888-939-3333 | cancer.ca | © 2024 Canadian Cancer Society