About cancerTypes of cancerVaginal cancer

Diagnosing vaginal cancer

Expert content reviewers:

Prof Alison Brand, Director, Gynaecological Oncology, Westmead Hospital, NSW; Gemma Busuttil, Radiation Therapist, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Dr Ming-Yin Lin, Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Dr Lisa Mackenzie, Clinical Psychologist Registrar, HNE Centre for Gynaecological Cancer, Hunter New England Local Health District, NSW; Anne Mellon, CNC – Gynaecological Oncology, HNE Centre for Gynaecological Cancer, Hunter New England Local Health District, NSW; A/Prof Tarek Meniawy, Medical Oncologist, Sir Charles Gairdner Hospital and The University of Western Australia, WA; Dr Archana Rao, Gynaecological Oncologist, Senior Staff Specialist, Royal Brisbane and Women’s Hospital, QLD; Tara Redemski, Senior Physiotherapist – Cancer and Blood Disorders, Gold Coast University Hospital, QLD; Angela Steenholdt, Consumer; Maria Veale, 13 11 20 Consultant, Cancer Council QLD.

Page last updated:

The information on this webpage was adapted from Understanding Vaginal Cancer (2023 edition). This webpage was last updated in October 2023.

Diagnosis

The main tests used to diagnose vaginal cancer are a physical examination, a cervical screening test, a procedure called a colposcopy, the removal of a tissue sample (biopsy), and imaging scans.

Physical examination

Your doctor will look at your vagina, groin and pelvic area. They may use an instrument called a speculum to separate the vaginal walls so they can check the vagina and cervix for cancer.

Cervical screening test

This test looks for cancer-causing types of HPV in a sample of cells taken from the cervix or vagina. During the physical examination, the doctor uses a small brush or swab to remove some cells from the surface of the cervix. This test replaced the Pap test in 2017.

Colposcopy

This uses a magnifying instrument called a colposcope to look at the vulva, vagina and cervix and see if there are any abnormal or changed cells. The colposcope is placed near your vulva but does not enter your body.

Biopsy

During a colposcopy, your doctor will usually take a small tissue sample (biopsy) from the vaginal area. If you have a condition that has narrowed the vagina, you may need to have a biopsy under general anaesthetic. The tissue sample will be sent to a laboratory for testing. A biopsy is the best way to diagnose vaginal cancer.

Imaging scans

If vaginal cancer is found, you may have one or more imaging scans to check if the cancer has spread to other parts of your body. These scans may include a chest x-ray, MRI or PET–CT scan. To find out more about these scans, visit your local Cancer Council website or call Cancer Council 13 11 20.

What are lymph nodes?

Lymph nodes are part of your body’s lymphatic (drainage) system. The lymphatic system is a network of vessels, tissues and organs that helps to protect the body against disease and infection. There are large groups of lymph nodes in the neck, armpits and groin. Sometimes vaginal cancer can travel through the lymphatic system to other parts of the body. To work out if the vaginal cancer has spread, your doctor may check the lymph nodes.

Staging vaginal cancer

Staging describes the size of the cancer and how far it has spread. Knowing the stage helps doctors recommend the best treatment for you.

Stages of vaginal cancer

Stage 1: Cancer is found only on the vaginal surface; not spread to lymph nodes.
Stage 2: Cancer has begun to spread through the vaginal wall, but has not spread into the wall of the pelvis or to the lymph nodes.
Stage 3: Cancer has spread to the pelvis, lower part of the vagina, or is blocking the urinary tract. It may also have spread to nearby lymph nodes.
Stage 4: Cancer has spread to the bladder, rectum, or more distant parts of the body, such as the lungs or bone. It may have spread to lymph nodes.

Questions for your doctor

What type of vaginal cancer do I have? Has the cancer spread?
What treatment do you recommend? What are the risks and possible side effects?
Are there any other treatment options for me?
Will the treatment affect my sexual function or pleasure? Will the treatment affect my fertility?
Do I have HPV? Can I pass on HPV to my partner?
How often will I need check-ups after treatment?
What will happen at each follow-up appointment?
If the cancer comes back, how will I know? What treatments could I have then?