The risk of vulvar cancer can be reduced by avoiding certain risk factors and by treating pre-cancerous conditions before an invasive cancer develops. These steps cannot guarantee prevention but can greatly reduce your chances of developing vulvar cancer.

Avoiding risk factors

HPV infection

Infection with human papilloma virus (HPV) is a vulvar cancer risk factor. HPV infections occur mainly in young women and are less common in women over 30. The reason for this is not clear.

Certain types of sexual behavior increase a woman's risk of getting HPV infection, such as:

• having sex at an early age
• having many sexual partners
• having a partner who has had many sex partners
• having sex with uncircumcised males

Delaying sex until you are older can help you avoid HPV. It also helps to limit your number of sexual partners and to avoid having sex with someone who has had many other sexual partners. Men who have not been circumcised are more likely to be infected with HPV and pass it on to their partners. This may be because the surface of the foreskin (which is removed by circumcision) is more easily infected by HPV. Remember that HPV can be present for years with no symptoms - it does not always cause warts or any other symptoms. Someone can have the virus and pass it on without knowing it.

Condoms provide some protection against HPV. One study found that when condoms are used correctly they can lower the HPV infection rate by about 70% - if they are used every time sex occurs. Condoms cannot protect completely because they don't cover every possible HPV-infected area of the body, such as the skin of the genital or anal area. Still, condoms do provide some protection against HPV, and they also protect against HIV and some other sexually transmitted diseases.

Vaccines have been developed to help prevent infection with some types of HPV. Right now, there is an HPV vaccine that has been approved for use in the US by the Food and Drug Administration (FDA). This vaccine is called Gardasil®, and it protects against HPV types 6, 11, 16, and 18. It is currently recommended for use in young females before they become sexually active. This vaccine was designed to lower the risk of cervical cancers and pre-cancers, but it also can prevent vulvar cancers and pre-cancers caused by HPV 16 and 18. More HPV vaccines are being developed and tested.

Smoking

Not smoking is another way to lower vulvar cancer risk. Women who don't smoke are also less likely to develop a number of other cancers, such as those of the lungs, mouth, throat, bladder, kidneys, and several other organs.

Detecting pre-cancerous conditions

Pre-cancerous vulvar conditions that are not causing any symptoms can be found through regular gynecologic checkups. It is also important to see your health care provider if any problems come up between checkups. Symptoms such as vulvar itching, rashes, moles, or lumps that don't go away could be caused by vulvar pre-cancer and should be checked out. If VIN is found, treating it may help prevent invasive squamous cell vulvar cancer. Also, some vulvar melanomas can be prevented by removing atypical moles.

Examination of the vulva is done at the same time a woman has a Pap test and pelvic examination. The Pap test is not used to screen for vulvar cancer. The purpose of the Pap test is to find cervical cancers and pre-cancers early. The American Cancer Society recommends these guidelines for the early detection of cervical cancer:

• All women should begin cervical cancer screening about 3 years after they start having sex (vaginal intercourse). A woman who waits until she is over 18 to have sex should start screening no later than age 21. Screening should be done every year with the regular Pap test. If the newer liquid-based Pap test is used, testing can be done every 2 years.

• Beginning at age 30, women who have had 3 normal Pap test results in a row may be screened less often - every 2 to 3 years. Testing can be with either the conventional (regular) or liquid-based Pap test. Some women should continue getting tested yearly - such as those exposed to diethylstilbestrol (DES) before birth, and those with a weakened immune system (from HIV infection, an organ transplant, chemotherapy, or chronic steroid use).

• Another reasonable option for women over 30 is to get screened every 3 years (but not more frequently) with either the conventional or liquid-based Pap test, plus the HPV DNA test.

• Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection, or a weakened immune system should continue to have screening as long as they are in good health.

• Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix need to continue cervical cancer screening, and should continue to follow the guidelines above.

See the American Cancer Society documents Cervical Cancer, and Cervical Cancer: Prevention and Early Detection for more information about finding female reproductive system cancers early.

Self-examination of the vulva is also a way to find vulvar cancer early. You can become aware of any changes in the skin of your vulva by examining yourself monthly using a mirror. Look for any areas that are white, darkly pigmented, or red and irritated. You should also note any new growths, nodules, bumps, or ulcers (open sores). Report any of these to a doctor, since they could indicate vulvar cancers or pre-cancerous conditions.

Last Medical Review: 12/30/2008
Last Revised: 05/14/2009