The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on September 21, 2021.

About vaginal cancer

Vaginal cancer is a rare disease that develops in the tissues of the vagina, also known as the birth canal. Despite its low incidence, vaginal cancer has many types. According to the American Cancer Society, about 1 in every 1,100 women will develop vaginal cancer in her lifetime. An estimated 8,180 women in the United States are expected to be diagnosed with the disease in 2021.

The vast majority of vaginal cancers are squamous cell cancers. If left untreated, these cancer cells may grow through the vaginal wall and spread to nearby tissues or to other parts of the body, most frequently to the lungs, liver and bones.

What causes vaginal cancer?

Although cancer research has not identified all the causes of vaginal cancer, certain factors may increase risk for the disease, including age, smoking and previous conditions.

Risk factors for vaginal cancer may include:

  • Tobacco use
  • Lifestyle factors that include drinking alcohol
  • Vaginal adenosis
  • Certain types of HPV infection (human papillomavirus)
  • Previous diagnosis of cervical cancer or cervical dysplasia (a precancerous condition)
  • Family history that includes a mother who took diethylstilbestrol (DES), a hormonal drug used by pregnant women from 1940 to 1971 to prevent miscarriages (now linked to clear cell adenocarcinoma)

Learn about risk factors for vaginal cancer

Who gets vaginal cancer?

Approximately 85 percent of the cases of vaginal cancer occur in women over the age of 40. Nearly half the cases occur in women aged 70 or older. Women who smoke or drink are at greater risk of vaginal cancer. According to the National Cancer Institute, incidences of clear cell carcinoma caused by DES typically occur before age 30.

Vaginal cancer types

Types of vaginal cancer may include:

  • Squamous cell carcinoma, which is the most common type of the disease, developing from the thin, flat cells that line the surface of the vagina, or from a precancerous condition called vaginal intraepithelial neoplasia (VAIN), in which abnormal cells are found in the very top surface of the vaginal lining
  • Adenocarcinoma, which are cancer cells that begin in the glandular cells of the vagina and are more common in women after menopause
  • Melanomas
  • Sarcomas

Learn more about vaginal cancer types

Vaginal cancer symptoms

Symptoms usually do not develop until vaginal cancer is at an advanced stage, but chances of catching the disease are improved by having regular pelvic exams and Pap tests.

Symptoms of vaginal cancer may include:

  • Abnormal vaginal bleeding, unrelated to menstrual periods
  • Abnormal vaginal discharge
  • An obvious mass or lesion
  • Pain during sexual intercourse
  • Painful urination, constipation and continuous pain in the pelvic area in more advanced cases

Learn more about vaginal cancer symptoms

Diagnosing vaginal cancer

Procedures used for diagnosing vaginal cancer may include:

  • Biopsy, which can include tissue from the vagina, cervix or vulva
  • Colposcopy
  • Lymphadenectomy
  • Proctosigmoidoscopy and cystoscopy
  • Pelvic exam
  • Computed tomography scan (CT scan)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)/CT scan

Learn about diagnostic procedures for vaginal cancer

Vaginal cancer treatments

The first-line treatment for early-stage vaginal cancer patients is surgery.

Given that, treatment options for vaginal cancer may include:

  • Local excision, also called a wide excision, which includes removing a tumor and some of the surrounding normal tissue (the margin), possibly including nearby lymph nodes
  • Vaginectomy, which is the removal of the vagina and sometimes the surrounding supporting tissue (radical vaginectomy)
  • Trachelectomy, which is the removal of the cervix
  • Hysterectomy, which is the removal of the cervix and the uterus, or a radical hysterectomy, which also removes the surrounding tissue (the parametria), the upper part of the vagina, the lymph nodes in the pelvis and potentially the ovaries (based on the patient’s age)
  • Vaginal reconstruction
  • Pelvic exenteration, which is an extensive, rare type of surgery that may remove the uterus, cervix, vagina, ovaries, bladder, rectum and nearby lymph nodes if cancer returns after radiation therapy
  • Chemotherapy
  • Radiation therapy, including external beam radiation therapy (EBRT) and high-dose rate (HDR) brachytherapy (internal radiation)

Learn about treatment options for vaginal cancer