Vulvar cancer risk factors include:
- Cigarette smoking
- Lichen sclerosus (ivory-white patches on the skin around the genitals)
- Squamous cell hyperplasia
- Vulvar Intraepithelial Neoplasia (VIN) – pre-cancerous lesions
- History of cervical dysplasia
- History of anal or cervical cancer
- HIV infection
- Immunodeficiency due to organ transplant or chronic steroid use
- Caucasian ancestry
There exist two independent pathways associated with the development of vulvar cancer. The pathways are associated with differing risk factors as well. The pathways are:
High-risk HPV infections are a well-established causal agent in cervical cancers. The link is similar in vulvar cancers as well. HPV-associated cancers of the vulva are typically squamous cell carcinomas and occur more frequently in younger women. VIN is more frequently associated with cigarette smoking.
Chronic irritation associated with lichen sclerosus leads to atypical changes within the cells that cover the vulva. These too are associated with squamous cell carcinoma, though in contrast to HPV-related tumors, these tumors tend to occur in older women.