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Vaginal cancer

Amer Karam, MD
Jonathan S Berek, MD, MMS
Elizabeth A Kidd, MD
Section Editors
Barbara Goff, MD
Arno J Mundt, MD
Don S Dizon, MD, FACP
Deputy Editors
Sadhna R Vora, MD
Sandy J Falk, MD, FACOG


Primary cancer of the vagina comprises approximately 3 percent of all malignant neoplasms of the female genital tract. In the United States for example, vaginal cancer accounts for approximately 4000 cases and over 900 deaths annually [1].

Most of these tumors are squamous cell carcinomas, but melanoma, sarcoma, adenocarcinoma, and other histologic types also occur (table 1). Although primary vaginal cancer is rare, metastatic disease to the vagina or local extension from adjacent gynecologic structures is not uncommon. As a result, the majority of vaginal malignancies are metastatic, often arising from the endometrium, cervix, vulva, ovary, breast, rectum, and kidney [2-5]. Vaginal metastases may occur by direct extension (eg, cervix, vulva, endometrium) or by lymphatic or hematogenous spread (eg, breast, ovary, kidney).

The clinical manifestations, evaluation, and therapy of invasive vaginal cancer are reviewed here. Vaginal intraepithelial neoplasia is discussed elsewhere. (See "Vaginal intraepithelial neoplasia".)


Approximately 1 in 100,000 women will be diagnosed with in situ or invasive vaginal cancer (typically of squamous cell histology) [6,7]. The mean age at diagnosis of squamous cell carcinoma, the most common histologic type of vaginal cancer, is approximately 60 years, although the disease is seen occasionally in women in their 20s and 30s. Squamous carcinoma is more common as the age of the patient increases [6].

Most cases of vaginal cancer are likely mediated by human papillomavirus (HPV) infection, as with cervical cancer [8]. In a case-control study of 156 women with in situ or invasive vaginal cancer, over 50 percent were positive for antibodies to HPV subtypes 16 or 18 [9]. Thus, vaginal cancer has the same risk factors as cervical neoplasia: multiple lifetime sexual partners, early age at first intercourse, and being a current smoker [9,10].

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Literature review current through: Nov 2017. | This topic last updated: Aug 17, 2017.
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