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Vaginal Cancer
If you have vaginal cancer or are close to someone who does, knowing what to expect might be helpful. Here you can find information about vaginal cancer, including risk factors, symptoms, how it’s found, and how it’s diagnosed and treated.
About vaginal cancer
Vaginal cancer starts when cells in the vagina start to grow out of control. There are many different types of vaginal cancer. The most common type is squamous cell carcinoma, which starts in the lining of the vagina.
The vagina
The vagina is the canal between the vulva (the external female genitals) and the cervix (the lower part of the uterus). The vaginal walls usually touch each other but have many folds that help the vagina open and expand during sex or the birth of a baby.
Several different types of cells and tissues are found in the vagina:
- The lining of the vagina has a layer of flat cells on its surface called squamous cells. This layer of cells is called the epithelium.
- The vaginal wall underneath the epithelium is made up of connective tissue, muscle, lymph and blood vessels, and nerves.
- Glands near the opening of the vagina make mucus to keep the vaginal lining moist.
Vaginal precancer (VaIN)
Precancers are a group of cells that look or behave abnormally. They are not cancer, but they could become cancer over time. Vaginal intraepithelial neoplasia (VaIN) means that the abnormal cells are only found in the innermost surface layer of the vagina, or the epithelium.
The 3 grades of VaIN are based on how deep the abnormal cells are located within the epithelium.
- VaIN 1 (LSIL, low-grade VaIN): Involves a third of the vaginal epithelium. It might go away on its own but can sometimes lead to cancer if not treated.
- VaIN 2 or 3 (HSIL, high-grade VaIN): Involves more of the vaginal epithelium than VaIN 1. VaIN 3 is the closest to a true cancer.
- Carcinoma in situ: Involves the entire thickness of the epithelium.
How is VaIN found?
Although screening is not recommended for VaIN, it might be found when HPV or Pap testing is done to screen for cervical cancer. These tests might pick up cells from the vaginal lining. This allows some cases of VaIN to be found in people whose vaginal lining is not intentionally sampled.
Vaginal cancer and VaIN are more common in people who have tested positive for human papilloma virus (HPV), or who’ve had a cervical precancer or cancer. In people whose cervix has been removed to treat cervical cancer or precancer, samples might be taken from the lining of the upper vagina to look for cervical cancer that has come back, early vaginal cancer, or VaIN.
Types of vaginal cancer
Though quite rare, there are many types of vaginal cancer. Each type develops from a different type of cell in the vagina.
Most cases of vaginal cancer are squamous cell carcinomas. These cancers start in the squamous cells that make up the epithelium of the vagina. They’re most common in the upper part of the vagina near the cervix. If not treated, they can grow deeper into and through the vaginal wall and spread to nearby tissues over time. They can also spread to other parts of the body, most often the lungs, but also the liver and bones.
These cancers often slowly progress from VaIN to cancer over many years.
Cancers that begin in gland cells are called adenocarcinomas. These vaginal cancers are far less common than squamous cell carcinomas but might be found in certain people. For example, vaginal cancer in women younger than age 20 is more likely to be an adenocarcinoma.
A type of adenocarcinoma, called clear cell adenocarcinoma, is more common in young women who were exposed to diethylstilbestrol (DES) in their mother’s womb before birth. See Risk Factors for Vaginal Cancer for more information.
Melanoma
Melanomas start in pigment-producing cells that give skin its color. These cancers are usually found on sun-exposed areas of the skin but also can form in the vagina or other internal organs.
Melanoma tends to affect the lower or outer portion of the vagina. The tumors vary greatly in size, color, and growth pattern. Although vaginal melanomas can be blue, black, or brown, many are nonpigmented. See Melanoma Skin Cancer for more information.
Sarcoma
Sarcomas are cancers that start in the cells of bones, muscles, or connective tissue. These cancers form deep in the wall of the vagina, not on its surface.
There are several types of vaginal sarcomas. Rhabdomyosarcoma is the most common type of sarcoma that affects the vagina. It’s most often found in infants and young children and is rare in adults. Other vaginal sarcomas include leiomyosarcomas, endometrial stromal sarcomas, and carcinosarcomas.
Cancers that spread to the vagina
Cancers found in the vagina often start in other organsm, such as the cervix, uterus, rectum, or bladder, and then spread to the vagina. These cancers are named after the place they started. This is much more common than having vaginal cancer, which starts in the vagina.
If a cancer is growing in both the cervix and vagina, it is considered a cervical cancer. If the cancer involves both the vulva and the vagina, it’s considered a vulvar cancer.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
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Last Revised: October 23, 2026
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