Vaginal Cancer (VGC)
Vaginal Cancer (VGC): Causes and Risk Factors
Vaginal cancer (VGC) is a rare malignancy that primarily affects women over the age of 60, with risk increasing significantly in older age groups, especially those over 70. The development of vaginal cancer is strongly linked to several risk factors, most notably infection with the human papillomavirus (HPV).
Key Causes and Risk Factors
- Human Papillomavirus (HPV) Infection:
The main risk factor for vaginal cancer is persistent infection with high-risk HPV types, particularly HPV 16 and 18. HPV is a sexually transmitted virus that can cause pre-cancerous changes in vaginal cells (vaginal intraepithelial neoplasia, VAIN) and cervical cells (cervical intraepithelial neoplasia, CIN). While many HPV infections clear spontaneously, persistent infection increases cancer risk. - Age:
Vaginal cancer is more common in women over 60 years old, with nearly half of cases diagnosed in women aged 70 or older. - Weakened Immune System:
Conditions that impair immune function, such as HIV/AIDS or autoimmune diseases, reduce the body’s ability to clear HPV infections, increasing cancer risk. - History of Cervical Cancer or Precancerous Changes:
Women who have had cervical cancer or precancerous cervical lesions are at increased risk of developing vaginal cancer, likely due to shared HPV-related causes. - Vaginal Intraepithelial Neoplasia (VAIN):
Pre-cancerous changes in the vaginal lining caused by persistent HPV infection can progress to vaginal cancer if untreated. - Smoking:
Smoking more than doubles the risk of vaginal cancer, possibly by weakening the immune system and promoting carcinogenic changes. - Exposure to Diethylstilbestrol (DES):
Women whose mothers took DES during pregnancy have a higher risk of a rare type of vaginal cancer called clear cell adenocarcinoma. - Vaginal Adenosis:
The presence of glandular cells in the vagina (vaginal adenosis) increases cancer risk. - Pelvic Radiotherapy:
Prior radiation treatment to the pelvis slightly increases the risk. - Multiple Sexual Partners and Early Sexual Activity:
These factors increase the likelihood of acquiring HPV infection.
Additional Considerations
- Vaginal cancer can occur even in women who have had a hysterectomy or in transgender and non-binary individuals with vaginal tissue.
- Alcohol consumption‘s role is unclear, with some studies suggesting increased risk but others showing no strong association after adjusting for confounders.
Prevention
- HPV Vaccination: Protects against high-risk HPV types and reduces the risk of HPV-related vaginal and cervical cancers.
- Regular Cervical Screening: Detects precancerous changes early, allowing treatment before progression.
- Safe Sexual Practices: Use of condoms reduces HPV transmission risk but does not eliminate it completely.
- Smoking Cessation: Reduces risk by improving immune function and reducing carcinogen exposure.
Summary Table
| Risk Factor | Description |
|---|---|
| Human Papillomavirus (HPV) | Main cause; high-risk types 16 and 18 linked to vaginal cancer and precancerous lesions |
| Age | Most cases occur in women over 60, especially over 70 |
| Weakened Immune System (e.g., HIV/AIDS) | Increases risk by impairing clearance of HPV infection |
| History of Cervical Cancer or CIN | Shared HPV-related risk increases vaginal cancer risk |
| Vaginal Intraepithelial Neoplasia (VAIN) | Pre-cancerous vaginal cell changes caused by HPV |
| Smoking | More than doubles risk by weakening immunity and promoting carcinogenesis |
| Diethylstilbestrol (DES) Exposure | In utero exposure linked to clear cell adenocarcinoma |
| Vaginal Adenosis | Presence of glandular cells in vagina increases risk |
| Pelvic Radiotherapy | Slightly increased risk after radiation treatment |
| Sexual Behavior | Multiple partners and early sexual activity increase HPV exposure risk |
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References
- Macmillan Cancer Support. Causes and risk factors of vaginal cancer.
https://www.macmillan.org.uk/cancer-information-and-support/vaginal-cancer/vaginal-cancer-causes - American Cancer Society. Risk Factors for Vaginal Cancer.
https://www.cancer.org/cancer/types/vaginal-cancer/causes-risks-prevention/risk-factors.html - Cancer Research UK. Risks and causes of vaginal cancer.
https://www.cancerresearchuk.org/about-cancer/vaginal-cancer/risk-causes - Mayo Clinic. Vaginal cancer – Symptoms and causes.
https://www.mayoclinic.org/diseases-conditions/vaginal-cancer/symptoms-causes/syc-20352447 - University of Rochester Medical Center. Vaginal Cancer: Risk Factors.
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=34&contentid=19527-1 - NHS. Causes of vaginal cancer.
https://www.nhs.uk/conditions/vaginal-cancer/causes/ - Society of Gynecologic Oncology. Vaginal Cancer: Risk Factors.
https://www.sgo.org/patient-resources/vaginal-cancer/vaginal-cancer-risk-factors/
Vaginal cancer is strongly linked to persistent high-risk HPV infection, older age, immune suppression, smoking, and certain pre-existing vaginal or cervical conditions. Preventive measures like HPV vaccination, cervical screening, smoking cessation, and safe sexual practices can reduce risk.
