Most vaginal squamous cell cancers are believed to start out as pre-cancerous changes, called vaginal intraepithelial neoplasia or VAIN. VAIN may be present for years before turning into a true (invasive) cancer. Screening for cervical cancer (such as with a Pap test and HPV test) can sometimes pick up these pre-cancers or problems that might lead to them forming. If a pre-cancer is found, it can be treated, stopping cancer before it really starts.
Still, since vaginal cancer and VAIN are rare, doctors seldom do other tests to look for these conditions in women who don't have symptoms or a history of pre-cancer or cancer of the cervix, vagina, or vulva.
Vaginal intraepithelial neoplasia (VAIN; pre-cancer of the vagina) may not be visible during a routine exam of the vagina. But it may be found with testing that's done to screen for cervical cancer. Because cervical cancer is much more common than vaginal cancer, the HPV test and Pap test that are used for cervical cancer screening take samples from the cervix. But some cells of the vaginal lining are usually also picked up at the same time a Pap smear might be done. This allows some cases of VAIN to be found in women whose vaginal lining is not intentionally scraped. Still, the main goal of these tests is to find cervical pre-cancers and early cervical cancers, not vaginal cancer or VAIN.
In women whose cervix has been removed by surgery to treat cervical cancer or pre-cancer, samples may be taken from the lining of the upper vagina to look for cervical cancer that has come back, and to look for early vaginal cancer or VAIN. Vaginal cancer and VAIN are more common in women who have had cervical cancer or pre-cancer.
Many women with VAIN may also have a pre-cancer of the cervix (known as cervical intraepithelial neoplasia or CIN). If abnormal cells are found, the next step is a procedure called colposcopy, in which the cervix, the vagina, and at times the vulva are closely examined with a special instrument called a colposcope.
Vaginal cancer develops in the vagina, the muscular, tube-like structure that extends from the cervix, at the bottom of the uterus, to the vulva, which is the outer part of a woman’s genitals. It is an extremely rare type of cancer.
NYU Langone doctors recommend several measures to help prevent vaginal cancer, including vaccination against human papillomavirus (HPV), practicing safer sex, smoking cessation, and the management of precancerous lesions.
NYU Langone doctors recommend vaccination against HPV to prevent vaginal cancer as well as cancers of the cervix, vulva, penis, and anus.
There are more than 150 types of HPV, which are usually spread through skin-to-skin contact during vaginal, oral, or anal sex. Some strains of the virus—including HPV 16 and HPV 18—are associated with vaginal cancer.
Vaginal Cancer After PeriodHPV is common: about 14 million Americans become infected each year. Nearly all sexually active women are infected with some type of HPV during their lives. Many experience no symptoms because the immune system usually rids the body of the virus within a few years of infection.
Over time, HPV infection may cause abnormal changes in the squamous cells that line the vagina. These may be precancerous, increasing a woman’s risk of developing a form of vaginal cancer called squamous cell carcinoma.
These precancerous changes are called vaginal intraepithelial neoplasia, or dysplasia. Sometimes they go away, as cells revert back to normal after the body has cleared the virus. Cells infected with HPV can take years, even decades, to develop into cancer.
There is no cure for HPV infection, but it can be prevented with vaccination. Doctors recommend HPV vaccination for women and girls before they are sexually active. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends that the three-dose vaccine be given to girls at age 11 or 12, although it may be given to those as young as age 9. Vaccination is also recommended for girls and women ages 13 to 26 who have not been vaccinated or have not received all three scheduled doses. The vaccine is not recommended for women older than age 26, because it has not yet been well studied in this age group.
The Advisory Committee recommends vaccination for boys age 11 or 12 and in boys or young men 13 to 21 years old who were not previously vaccinated. The vaccine is also available for men up to age 26 who are at an increased risk of infection, because they have sex with men or have a weakened immune system.
Vaccination helps to prevent the spread of HPV to sexual partners and prevents vaginal cancer and other HPV-related cancers.
Researchers are investigating whether the vaccine prevents oropharyngeal cancer, which is cancer that develops on the back of the tongue, the tonsils, the soft palate or roof of the mouth, and the sides and back wall of the throat.
Practicing safer sex by using condoms or other barrier methods during vaginal, oral, and anal sex can help to reduce the risk of HPV infection. However, these methods do not eliminate the risk of cancer.
Safer sex can also reduce the risk of infection with other sexually transmitted diseases, such as human immunodeficiency virus (HIV). HIV infection also increases vaginal cancer risk.
Smoking cigarettes increases the risk of developing vaginal cancer, as well as many other types of cancer. Perlmutter Cancer Center’s Tobacco Cessation Programs can help women quit, reducing their cancer risk.
If your doctor finds precancerous changes in cells of the vagina, he or she can recommend effective treatment options that help reduce the chance of cancer developing.
