Vulvar cancer is rare. It accounts for a small fraction of all cancers in women, with roughly 2 to 3 cases per 100,000 women diagnosed each year in the United States. About 6,900 new cases are estimated annually, making it one of the least common gynecological cancers. Still, incidence has been rising steadily, particularly among certain age and racial groups, which makes understanding the numbers worth your time.
How Vulvar Cancer Compares to Other Cancers
To put the rarity in perspective, vulvar cancer represents about 0.7% of all cancers in women and roughly 6% of gynecological cancers specifically. It is far less common than cervical, uterine, or ovarian cancers. Most gynecologists will see relatively few cases over the course of a career, and many women have never heard of it before receiving a diagnosis.
That said, rates are not static. A large study of over 75,000 cases spanning 16 years found that the average annual percent change in incidence among White women was 1.1% per year. Black women saw a 0.7% annual increase. Hispanic women showed essentially stable rates. The overall trend is upward, and researchers are still working to understand exactly why.
Who Gets It Most Often
Vulvar cancer is primarily a disease of older women. Most diagnoses occur after age 60, and risk increases with each decade of life. However, the sharpest recent increases have appeared in a somewhat younger group. White women between 50 and 59 had the highest incidence in recent data, reaching 5.0 per 100,000 in 2017, with an annual increase of 2.5%.
Racial differences exist. In the large study of 75,767 patients, 85.3% were White, 7.8% were Black, 5.4% were Hispanic, and 1.4% were Asian or Pacific Islander. White women carry the highest overall risk, though Black women face worse outcomes once diagnosed, likely due to later-stage detection and disparities in access to care.
Two Distinct Pathways to Vulvar Cancer
Vulvar cancer develops through two main routes, and understanding these helps explain who is at risk. The first involves infection with high-risk strains of human papillomavirus (HPV). Data from seven U.S. cancer registries found HPV DNA in approximately 69% of invasive vulvar cancers. HPV 16 alone was present in about 48% of those cases. This HPV-driven pathway tends to affect younger women and is the same virus linked to cervical cancer.
The second pathway is independent of HPV and typically involves chronic skin conditions of the vulva, most notably lichen sclerosus. This is a long-term inflammatory condition that causes itching, thinning skin, and white patches. Studies estimate that 3.5% to 7% of women with vulvar lichen sclerosus will eventually develop vulvar squamous cell carcinoma, with one study putting the figure at 6.25%. This pathway is more common in older women and often involves years of chronic inflammation before cancer appears.
The Main Type and Less Common Forms
Squamous cell carcinoma dominates. It accounts for at least 75% of all vulvar cancers. This is the type linked to both HPV and lichen sclerosus. The remaining cases include melanoma (the same type of cancer that occurs on sun-exposed skin, but appearing on vulvar tissue), basal cell carcinoma, cancers of the Bartholin glands, sarcomas, and Paget disease of the vulva. Each of these is individually very rare.
No Routine Screening Test Exists
Unlike cervical cancer, which has the Pap test and HPV testing, there is no reliable screening test for vulvar cancer in women without symptoms. The CDC states this clearly: the Pap test does not screen for vulvar cancer. This means that early detection depends almost entirely on you noticing changes and bringing them to a doctor’s attention.
The symptoms to be aware of include persistent itching, a visible lump or sore that doesn’t heal, changes in skin color or texture, pain, or bleeding unrelated to menstruation. Many of these overlap with benign conditions, which is why they’re often dismissed or treated for months before a biopsy is performed. Women with lichen sclerosus or a history of HPV-related precancerous changes benefit from regular vulvar examinations by a gynecologist, even though no formal screening program exists for the general population.
Survival Depends Heavily on Stage
When caught early, vulvar cancer has a strong survival outlook. The five-year relative survival rate for localized disease (cancer confined to the vulva) is 85.7%. That number drops significantly once cancer has spread to nearby lymph nodes or tissues: regional-stage disease has a five-year survival of 49.7%. For distant-stage disease, where cancer has spread to organs farther away, survival falls to 21.9%.
These numbers, drawn from SEER data covering 2015 through 2021, underscore why early detection matters so much for a cancer with no screening test. The majority of vulvar cancers are caught at the localized stage, which is the good news. But because symptoms can mimic common, harmless conditions like yeast infections or skin irritation, delays in diagnosis remain a real problem. Any vulvar symptom that persists for more than a few weeks, particularly a sore that won’t heal or a patch of skin that looks or feels different, warrants a medical evaluation rather than watchful waiting.