Gynaecological cancer

A risk factor is something which can increase your chance of being diagnosed with cancer, and different cancers have different risk factors associated with them.

Some risk factors, like your age and genetics or family history, can’t be changed, whereas other lifestyle risk factors like smoking and diet, can be modified.

It’s important to understand that risk factors increase your chance of being diagnosed with cancer but they do not mean that you will be diagnosed with cancer. Many people with a known risk factor or multiple risk factors do not develop cancer, in the same way that a person with no known risk factors may be diagnosed with cancer. Risk factors are just one contributing factor to a cancer diagnosis, but understanding your own personal risk factors can help you be more aware and proactively manage them.

Age

As is the case with many cancers, your risk of ovarian cancer increases with age, increasing significantly from the age of 45 and being most common in people aged 75 and over. It’s important to remember that whilst ovarian cancer is less common in younger people it is still possible to be diagnosed with ovarian cancer at any age, so be sure to speak to a doctor if you experience any symptoms or notice any change to your health.

Genetics

Some ovarian cancers, estimated to be between 5% and 15%, are also linked to genetic conditions, which run in families. Your risk of developing ovarian cancer may be higher if you have a family history, this is known as an inherited genetic risk.

If you have a mother or a sister who has been diagnosed with ovarian cancer this increases your personal risk around 3 times. The inherited genes that increase the risk of ovarian cancer include faulty versions of BRCA1 and BRCA2. Faults in these genes also increase the risk of breast cancer.

If you do have a family history of ovarian cancer and are concerned about your own risk, you could benefit from visiting a consultant geneticist. Our highly experienced consultants in clinical genetics specialise in assessing the risk for inherited conditions and managing genetic disorders.

During your consultation at one of our dedicated genetic clinics, your consultant geneticist will review your medical history, and discuss your family’s medical history, to assess your cancer risk. They will help you to understand your personal risk and the options which are available to you.

Your geneticist may recommend that you have a cancer genetic test to discover whether you are carrying a genetic mutation that could cause ovarian cancer. If you choose to have a genetic test and discover that you do have an inherited genetic predisposition to ovarian cancer, we understand that this can be a worrying time and you will likely have a number of questions or concerns. Our specially trained genetic counsellors can support you and your family along with the input of our wider multidisciplinary team.

It’s important to remember that being diagnosed with one of these genetic conditions increases your risk but does not mean you will definitely be diagnosed with cancer in your lifetime. Your consultant can discuss this with you in more detail, along with any recommendations on risk-reducing strategies.

There are several known risk factors for uterine cancer which include:

Age

Most uterine cancers occur after the age of 50, with the average age at diagnosis being 60, so as you get older your chance of developing uterine cancer increases. Uterine cancer is rare in people under the age of 45.

Diet

A diet which is high in animal fat increases your risk of uterine and several other cancers. High fat foods also contain lots of calories which can lead to excess fat and obesity, which is another risk factor for uterine cancer.

Obesity

People with a body mass index (BMI), which is the ratio of your weight to height, that is 30.0 or higher are categorised as obese and are at an increased risk of uterine and other cancers. Fatty tissue produces excess oestrogen, a sex hormone which can increase the risk of uterine cancer. The more excess fatty tissue you carry, the greater the effect on oestrogen levels.

Diabetes

You may be at an increased risk of uterine cancer if you have Type 2 diabetes, which is often related to obesity.

Genetics

Some uterine cancers are linked to genetic conditions, also known as inherited risk, which run in families. Your risk of developing uterine cancer may be higher if you have an inherited genetic risk, a genetic mutation (change) which is passed on from your parents. Hereditary nonpolyposis colorectal cancer (HNPCC) is an inherited condition which raises the risk of several different cancers, including uterine cancer. Learn more about hereditary cancer and genetic testing.

Menstrual and reproductive history

If your periods began early, before you were aged 12, your risk of uterine cancer may increase. This is because your uterus has been exposed to more oestrogen, a hormone which can increase the risk of uterine cancer.

If you had a late menopause, so after 50, this has a similar impact to starting your period at a younger age, as the total number of years you menstruate impacts your uterine cancer risk, based on your oestrogen exposure.

If you haven’t been pregnant this also increases your exposure to oestrogen and therefore your uterine cancer risk.

Radiotherapy

If you’ve had previous radiotherapy to treat other cancers in your pelvic area, which is the lower part of your abdomen between your hip bones, this can damage your cell DNA and can increase your risk of developing a second type of cancer, including uterine cancer.

Tamoxifen

Some people take a drug called Tamoxifen to reduce their risk of developing breast cancer or to help prevent a recurrence of breast cancer. If you take Tamoxifen you do have an increased risk of uterine cancer but the benefits usually outweigh this risk. If you are taking Tamoxifen and are concerned, you should discuss this with your doctor.

There are several shared risk factors for cervical, vaginal and vulval cancer which include:

Age

Your risk of vulval cancer increases with age, with fewer than 20% of vulval cancers being diagnosed in women under 50 years old, and over 50% of cases diagnosed in women aged 70 and over.

Your risk of vaginal cancer also increases with age, around 80% of people diagnosed are aged 50 and over with most cases occurring between the ages of 50 and 70 years old. However, cervical cancer, unlike other gynaecological cancers, is more common in younger people aged 45 and under.

High-risk human papillomavirus (HPV)

HPV is common in cervical, vaginal and vulval cancer diagnosis; almost all cases of cervical cancer, and more than half of all vaginal and vulval cancers, are caused by high-risk human papillomavirus (HPV).

Here, Mr Tim Mould, Consultant Gynaecological Oncologist at The Portland Hospital and The Princess Grace Hospital, both part of HCA Healthcare UK, answers the top 7 most commonly asked questions about HPV – including how common HPV is and whether you can have the HPV vaccine as an adult.

Smoking

Smoking can increase your risk of cervical, vaginal and vulval cancer as well as many other cancers. In fact, Smoking is the biggest preventable cause of cancer.

HIV (human immunodeficiency virus)

If you have been diagnosed with HIV this increases the risk of being diagnosed with cervical, vaginal and vulval cancer.

Additional risk factors for cervical cancer include:

Sexually transmitted infections

Your risk of cervical cancer may be higher if you have a sexually transmitted infection (STI), such as chlamydia, particularly if the STI is associated with the presence of HPV.

Practising safer sex with barrier methods, such as condoms, will reduce your risk of getting and passing on HPV and many other STI’s.

The contraceptive pill

Taking the contraceptive pill may increase your risk of being diagnosed with cervical cancer and the risk increases in line with the number of years that the pill is taken, for example taking the pill for longer than 5 years may increase the risk of cervical cancer.

If you stop taking the contraceptive pill this risk will begin to decline. Once you have stopped taking the pill for 10 years or more your risk will be similar to somebody who has never taken the pill.

Whilst taking the contraceptive pill may increase your risk of cervical cancer it’s important to note that taking the pill has also shown a risk reduction for ovarian and uterine cancers. If you are considering the benefits and risks of taking the contraceptive pill, or are already taking the pill and have concerns, you should discuss this with your doctor.

Having children

There is some evidence to suggest that women who have given birth might be at higher risk of cervical cancer than women who have not. The number of children you have given birth to and the age you were when you gave birth is considered to be of importance. Having a baby at a younger age than 17 year may increase the risk, compared with having a baby after 25 years of age.

Genetics

Some cervical cancers are linked to genetic conditions, also known as inherited risk, which run in families. Your risk of developing cervical cancer may be higher if you have a first-degree relative such as a mother, sister or daughter that has previously been diagnosed with or has cervical cancer. Learn more about hereditary cancer and genetic testing.

Additional risk factors for vaginal cancer include:

Cervical cancer or pre-cancerous changes

If you’ve previously been diagnosed with cervical cancer or have pre-cancerous changes known as cervical dysplasia or cervical intraepithelial neoplasia (CIN) this can increase your risk of developing vaginal cancer. If you have been diagnosed with one of these conditions and are concerned about your vaginal cancer risk, please speak to your doctor. 

Changes to your vaginal cells

A condition named vaginal intraepithelial neoplasia (VAIN) may indicate that you are more at risk of getting vaginal cancer. This condition is represented by changes in the cells located in the inner lining of the vagina. If left untreated, some of these changes may become cancerous. If you have been diagnosed with VAIN and are concerned about your vaginal cancer risk, please consult your doctor.

An additional risk factor for vulval cancer is Lichen sclerosus et atrophicus (LSA). This condition causes the vulval skin to become thin and itchy. The risk of vulval cancer is seen to be slightly increased by LSA, around 4% of people who have LSA will later develop vulval cancer.