The risk of vulvar cancer can be reduced by avoiding controllable 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

Human papillomavirus (HPV) infection is a vulvar cancer risk factor that can be reduced by avoiding certain sexual practices outlined in the section on risk factors and by delaying onset of sexual activity. Until recently, it was thought that the use of condoms ("rubbers") could prevent infection with HPV. But recent research shows that condoms cannot fully protect against infection with HPV. This is because HPV can be passed from one person to another by skin-to-skin contact with any HPV-infected area of the body such as skin of the genital or anal area not covered by the condom.

It is still important to use condoms to protect against HIV/AIDS and other sexually transmitted diseases that are passed on through some body fluids. Because HPV can be present for years with no symptoms and passed on to another person even when there are no visible symptoms, the absence of visible warts cannot be used to decide whether caution is warranted.

The earlier sexual contact with others is begun, the more likely it is that a person will become infected with HPV, and the more time any HPV infection will have to progress to cancer. For these reasons, postponing the beginning of sexual activity in life and limiting the number of sexual partners are 2 ways to reduce the risk of developing HPV infection and vulvar cancer.

A new vaccine has been approved by the FDA that will protect against infection with HPV types 16 and 18. It is currently recommended for use in young females before they become sexually active (to prevent cervical cancers and pre-cancers), and it is being looked at for possible use in males. While studies have not yet been done, the hope is that this may eventually help prevent other cancers linked to HPV, including vulvar cancers.

Not smoking is another way to lower vulvar cancer risk, in addition to obvious benefits of greatly reducing your risk of developing far more common cancers of the lungs, mouth, throat, bladder, kidneys, and several other organs.

Detecting Pre-cancerous Conditions

Pre-cancerous vulvar conditions can be identified by having regular reproductive system (gynecologic) checkups and by having a doctor evaluate any persistent vulvar rashes, moles, lumps, or other abnormalities. Treatment of vulvar intraepithelial neoplasia (VIN) can prevent many cases of invasive squamous cell vulvar cancer.

Some vulvar melanomas can be prevented by removal of atypical moles.

Examination of the vulva is routinely done at the same time a woman has a Pap test and pelvic examination. The American Cancer Society recommends:

• All women should begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the newer liquid-based Pap test.

• Beginning at age 30, women who have had 3 normal Pap test results in a row may get screened every 2 to 3 years with either the conventional (regular) or liquid-based Pap test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.

• 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 should continue to follow the guidelines above.

See the American Cancer Society documents on "Cervical Cancer," "Pap Test," and "Cancer Detection Guidelines" for more information about early detection of female reproductive system cancers.

Some doctors recommend self-examination of the vulva as a strategy for early detection of vulvar cancer, as well as certain other vulvar disorders. A woman can become aware of any changes in the skin of her vulva by examining herself monthly. Using a mirror, look for any areas that are red and irritated, white, or darkly pigmented. You should note any abnormal growths, nodules, bumps, or ulcers and report these to a doctor, since they may indicate vulvar cancers or pre-cancerous conditions.

Revised: 06/21/2006