Vaginal cancer

Primary vaginal cancer is any cancer that starts in the vagina. There are several types named after the cells they start in. Some cancers of the vagina have spread from a cancer elsewhere in the body. These are called secondary vaginal cancers.

Learn more about:

• The vulva and vagina
• Types of primary vaginal cancer
• Secondary vaginal cancer
• Who gets vaginal cancer?
• What causes vaginal cancer?

The vulva and vagina

The vulva and the vagina are parts of the female reproductive system, which also includes the ovaries, fallopian tubes, uterus and cervix.

The vulva

The vulva is a general term for a female’s external sexual organs (genitals). The main parts of the vulva are the:

• mons pubis – the soft, fatty mound of tissue covered with pubic hair, above the labia
• labia majora – two large, outer fleshy lips, which surround and protect the inner lips known as labia minora
• labia minora – two inner lips (may be smaller or thinner than the labia majora)
• clitoris – the main organ for sexual pleasure in females. It is located where the labia minora join at the top of the vulva. During arousal, the clitoris fills with blood and becomes erect, and touching it can lead to sexual climax (orgasm)
• Bartholin glands – two small glands near the opening of the vagina. They produce mucus to moisten (lubricate) the vagina.

The vagina

Sometimes called the birth canal, the vagina is a muscular tube about 7–10 cm long that extends from the cervix to the vulva. The vaginal opening is where menstrual blood flows out of the body during a period, sexual intercourse occurs, and a baby leaves the body.

Urethra, anus and perineum

Below the clitoris is the urethra, for passing urine. Further down is the entrance to the vagina, and behind that is the anus. The area of skin between the vagina and the anus is called the perineum.

The female reproductive system

Types of primary vaginal cancer

Squamous cell carcinoma (SCC)

• starts in the thin, flat (squamous) cells lining the vagina
• makes up about 85% of vaginal cancers

 Adenocarcinoma

• develops from the mucus-producing (glandular) cells of the vagina
• includes clear cell carcinoma
• makes up 5–10% of vaginal cancers

Vaginal (mucosal) melanoma

• starts in the cells that give the skin its colour (melanocytes), which are also found in the lining of the vagina
• a rare form of vaginal cancer

Sarcoma

• develops from muscle, fat and other tissue deep in the wall of the vagina
• a rare form of vaginal cancer

Who gets vaginal cancer?

Vaginal cancer is one of the rarest types of cancer affecting the female reproductive system (gynaecological cancer). Each year in Australia, about 100 women are diagnosed with vaginal cancer, and it is more common in women over 60. However, vaginal cancer, particularly adenocarcinoma, can sometimes occur in younger women.

Anyone with a vagina can get vaginal cancer – women, transgender men and intersex people. For information specific to your situation, speak to your doctor.

What causes vaginal cancer?

The exact cause of vaginal cancer is unknown, but there are several factors that increase the risk of developing it.

Vaginal intraepithelial neoplasia (VAIN)

This is a precancerous condition that often has no symptoms. It means that the cells in the lining of the vagina are abnormal and may develop into cancer after many years. However, most people with VAIN do not develop vaginal cancer.

Human papillomavirus (HPV)

HPV is a sexually transmitted infection that can cause some people to develop VAIN. It can be many years between infection with HPV and the first signs of VAIN or vaginal cancer. HPV is a common virus and most people with HPV don’t develop vaginal or any other type of cancer.

Smoking

Cigarette smoking may increase the risk of developing vaginal cancer. This may be because smoking can make the immune system work less effectively.

History of gynaecological cancer

If you have previously been diagnosed with cervical cancer or early cervical cell changes that were considered to be precancerous, you may be more likely to be diagnosed with vaginal cancer. For more on this, see Cervical cancer.

Diethylstilboestrol (DES)

This synthetic hormone drug has been identified as a cause of a type of vaginal adenocarcinoma called clear cell carcinoma.

Between 1938 and 1971 – and occasionally beyond – DES was prescribed to pregnant women to prevent miscarriages. It is no longer prescribed to pregnant women in Australia.

The female children of women who took DES (called DES daughters) have an increased risk of developing a range of health problems. About one in 1000 DES daughters develops clear cell carcinoma of the vagina or cervix.