Vaginal cancer

Wednesday 30 November, 2011

On this page: What is vaginal cancer? ι What are the symptoms? ι How common is it? ι What are the causes? ι More information ι Information reviewed by

The vulva and vagina are parts of the female reproductive system. The vagina is a muscular tube that is sometimes called the birth canal. It extends from the opening of the uterus to the external part of a woman's sex organs (vulva). The vagina is the passageway through which menstrual blood flows, sexual intercourse occurs, and a baby is born.

The opening of the vagina is below the clitoris. There are also small glands near the opening of the vagina, called Bartholin's glands, that produce mucus to lubricate the vagina.

The vulva and vagina

What is vaginal cancer?

There are two main types of cancer that start in the vagina:

  1. squamous cell carcinoma - the most common type of cancer, affecting cells covering the surface of the vagina
  2. adenocarcinoma - a type of cancer that begins in the glandular cells lining the vagina.

It is more common to have secondary cancers in the vagina. This means the cancer has spread from another part of the body. The cancer may spread from the cervix, uterus (womb), vulva, or nearby organs such as the bladder or bowel.

What are the symptoms?

There are often no obvious symptoms of vaginal cancer. The cancer may be found through a routine Pap smear.

You may have one or more of the following symptoms:

  • bloody or smelly vaginal discharge not related to your menstrual period
  • pain during sexual intercourse
  • bleeding after sexual intercourse
  • pain in the pelvic area
  • a lump in the vagina.

Some women also have bladder and bowel problems. You may have blood in your urine or feel the urge to pass urine frequently or during the night. Pain in the rectum can sometimes occur. If you have any symptoms, make an appointment with your GP.

How common is it?

Cancer of the vagina is one of the rarest types of gynaecological cancer. Each year in Australia, approximately 70 women are diagnosed.

Squamous cell carcinoma usually affects women aged 50-70. Adenocarcinoma commonly affects young women less than 25 years old, but it can also occur in other age groups.

What are the causes?

Some factors that increase the risk of vaginal cancer include:

Vaginal intraepithelial neoplasia (VAIN) - This is a precancerous condition of the vagina that is sometimes caused by human papillomavirus (HPV). It means that the cells are abnormal and they may develop into cancer. Not all women with VAIN develop cancer.

Vaginal adenosis - This condition causes abnormal cells to form in the tissue of the vagina. This is usually the result of DES exposure (see below).

Human papillomavirus (HPV) - Sometimes known as the wart virus, HPV is a sexually transmitted infection that increases the risk of vaginal cancer.

Smoking - Cigarette smoking doubles the risk of developing vaginal cancer.

Radiotherapy to the pelvis - If you have had radiotherapy to the pelvis for another reason, you are at a slightly higher risk of vaginal cancer. This complication is very rare.

Diethylstilboestrol (DES) - A synthetic hormone drug that has been identified as a cause of vaginal cancer. 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.

Female children of women who took DES (called DES daughters) have an increased risk of developing adenocarcinoma.

The risk appears to be highest for those in their teenage years and early 20s. However, older women have also been diagnosed, so DES daughters should have regular medical examinations throughout their lifetime.

Approximately one in 1,000 DES daughters develop adenocarcinoma, particularly a type called clear cell carcinoma.


History of gynaecological cancer - Cancer of the vagina is more likely to be diagnosed in women who have had cervical cancer or early cervical cell changes considered to be precancerous. It is sometimes more common in women who have had cancer of the uterus.

Vaginal cancer is not infectious and it can't be passed to other people through sexual contact. It is not caused by an inherited faulty gene and can't be passed on to children. 

More information

Being given a diagnosis of vaginal cancer can be very upsetting. Your doctor will explain your cancer and its treatment to you. You can also call the Cancer Council Helpline on 13 11 20 and speak with a cancer nurse. We can provide information and tell you about support services for women with cancer and their families and friends.

You may also find it helpful to visit the following websites:

This information was reviewed by:

Dr Greg Robertson, Gynaecological Oncologist, Royal Hospital for Women and St George Hospital; Jonathan Carter, Prof of Gynaecological Oncology, The University of Sydney and Head of Sydney Gynaecological Oncology Group, Sydney Cancer Centre; Belinda Fern, Consumer; Alicia Hiron, Consumer; Jayne Maidens, Clinical Nurse Consultant, Gynaecological Oncology Department, Royal North Shore Hospital; Anne Mellon, Clinical Nurse Consultant, Hunter New England Centre for Gynaecological Cancer, John Hunter Hospital; Fiona Pearce, Cancer Council NSW Helpline; Ann Tocker, Cancer Voices.

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