What lowers your risk
- Get the HPV vaccine if eligible — high-risk HPV types are linked to more than half of vulvar cancers, especially in younger women
- Do not smoke; smoking raises risk on its own, and much more so alongside a history of high-risk HPV
- If you are diagnosed with vulvar pre-cancer (VIN or high-grade SIL), have it treated rather than only watched — in one study 88% of untreated high-grade lesions progressed to cancer, against 4% of those treated
- If you have vulvar lichen sclerosus, stay on your prescribed treatment and get regular skin checks — about 4% of women with it go on to develop vulvar cancer
- If you are living with HIV, stay in care
- Report any new or persistent vulvar skin change rather than waiting it out; an early biopsy catches pre-cancer before it becomes cancer
Who is at higher risk
- Age — fewer than 20% of cases occur before 50, and more than half after 70; average age at diagnosis of invasive disease is 70
- Persistent high-risk HPV infection, which tends to produce vulvar cancer in younger women
- A history of vulvar pre-cancer (VIN/SIL) or vulvar lichen sclerosus
- Smoking, especially combined with prior HPV infection
- A personal history of cervical cancer
- Living with HIV
No screening test — but you can see this one
There is no routine screening test for vulvar cancer. It is not part of a standard Pap the way cervical screening is, though your doctor may inspect the vulva during a pelvic exam and biopsy anything that looks wrong.
Because the vulva is visible and can be self-examined, the most reliable early detection is paying attention to your own body and reporting changes. Almost every woman with invasive vulvar cancer has symptoms — this is not a silent disease. That is genuinely good news, and it is why the list below is the most useful thing on this page.
If you have lichen sclerosus or a history of VIN, ask your doctor for a regular vulvar skin-check schedule.
Signs worth reporting promptly
- A new lump, bump or wart-like growth
- A patch of skin that becomes thicker, rougher, or a different color — red, white or dark
- Itching, burning or soreness that does not go away
- An open sore or ulcer that does not heal
- New bleeding, spotting or discharge unrelated to your period
- A mole on the vulva that changes size, shape or color
What treatment involves
Treatment usually combines surgery, radiation and sometimes chemotherapy, with the mix depending heavily on stage and tumor size.
Surgery is often first for early disease — from a wide local excision removing the tumor with a margin of healthy tissue, up to a partial or radical vulvectomy, sometimes with removal of groin lymph nodes to check for spread.
Radiation plays a major role, both before surgery to shrink a large tumor and after surgery when cancer cells are found at or near the cut edge, or when lymph nodes are involved. It is given as external beam radiation to the vulva and groin, most often combined with chemotherapy to make it more effective. For women who are not well enough for surgery, radiation with chemotherapy can be the primary treatment instead.
Surgery and radiation here can affect sexual function, urination, and lymphatic drainage in the legs (lymphedema). Ask early about rehabilitation, pelvic floor therapy and lymphedema support. These belong in the plan from the start.
Questions to ask your care team
- What stage is my cancer, and what does that mean for my plan?
- Will I need surgery, radiation, chemotherapy, or a combination — and in what order?
- Will groin lymph nodes be removed or tested, and what does that mean for recovery?
- How likely is it that I will need radiation after surgery, and when will we know?
- What long-term effects — sexual, urinary or lymphedema — should I plan for?
- What support exists for those, and can I start before problems appear?
Where these numbers come from
Risk factors, progression figures, symptoms and treatment: American Cancer Society vulvar cancer pages (risk factors last revised May 2025). HPV attribution: Centers for Disease Control and Prevention.
Talk with our team
If something on your vulva has changed and you have been putting off asking, this is your sign to ask.