Is Vaginal Cancer Linked to HPV Infection?

Yes. Human papillomavirus (HPV) infection particularly high-risk strains HPV 16 and HPV 18 is strongly associated with vaginal squamous cell carcinoma, the most common histological type. The same HPV strains responsible for the majority of cervical cancers also play a role in vaginal and vulvar malignancies. Women with a prior history of cervical intraepithelial neoplasia (CIN) or cervical cancer carry an elevated risk of vaginal cancer, underscoring the importance of ongoing gynaecological surveillance even after treatment for cervical disease. Vaginal cancer is staged using the FIGO classification system, which guides the choice between surgical and radiation-based treatment approaches. Women seeking specialist care for HPV related cancer treatment in Noida can access gynaecological oncology services at IOCI Noida.

Types of Vaginal Cancer

Vaginal cancer is classified by the cell type of origin, which determines treatment approach and prognosis.

Squamous Cell Carcinoma: The most common type, accounting for approximately 85–90% of primary vaginal cancers. Arises from the squamous cells lining the vaginal wall. Strongly associated with HPV infection (particularly HPV 16 and 18). Most commonly occurs in the upper third of the vagina.

Adenocarcinoma: Arises from glandular cells. Accounts for a smaller proportion of primary vaginal cancers. Clear cell adenocarcinoma of the vagina is a recognised subtype historically associated with in utero diethylstilboestrol (DES) exposure — a drug used before 1971.

Melanoma: Primary vaginal melanoma is rare but known to be particularly aggressive. It arises from melanocytes in the vaginal mucosa. Surgical resection is the primary treatment; prognosis is generally poor due to late diagnosis and aggressive biology.

Sarcoma (Rhabdomyosarcoma): The most common vaginal cancer in children, arising from embryonal muscle cells. It typically presents as a polypoid mass (sarcoma botryoides). Treatment involves chemotherapy, surgery, and sometimes radiation — guided by paediatric oncology protocols.

Small Cell Neuroendocrine Carcinoma: Extremely rare; highly aggressive. Treated with chemotherapy-based regimens similar to those used for neuroendocrine carcinomas at other sites.

Secondary (Metastatic) Vaginal Cancer: More common than primary vaginal cancer. The vagina is a frequent site of metastatic spread from cervical, endometrial, ovarian, colorectal, or renal cancers. Treatment is directed at the primary cancer.

​Early Symptoms of Vaginal Cancer

Vaginal cancer may produce few or no symptoms in very early stages. When symptoms occur, they may include unusual vaginal bleeding particularly after intercourse or after menopause abnormal vaginal discharge, a palpable mass or lump in the vagina, pelvic pain or pressure, pain during intercourse, and difficulty or pain when urinating in more advanced cases. Any post-menopausal vaginal bleeding or bleeding after intercourse should be evaluated by a gynaecologist or gynae oncologist without delay.

Causes of Vaginal Cancer

Beyond HPV, additional risk factors include history of cervical cancer or vulvar cancer; prior radiotherapy to the pelvis; use of diethylstilboestrol (DES) in utero a drug used before 1971 associated with a rare type of vaginal cancer in daughters of women treated with it; vaginal intraepithelial neoplasia (VAIN), a pre-cancerous condition; immunosuppression, including HIV infection; and smoking, which increases HPV persistence and cancer risk.

Treatment Options at IOCI Noida

Radiation Therapy: The primary treatment modality for most stages of vaginal cancer — often a combination of external beam radiotherapy (EBRT) and brachytherapy (internal radiation delivered directly to the vaginal tumour). For locally advanced disease, concurrent chemotherapy (chemoradiation) may be added to improve local control.

Surgery: Early-stage, small vaginal tumours may be treated with surgical excision. More extensive surgery — including vaginectomy or pelvic exenteration for advanced or recurrent disease — carries significant morbidity and is considered carefully by a multidisciplinary team.

Chemotherapy: Systemic chemotherapy may be used alongside radiation or for metastatic disease. The vaginal cancer treatment cost varies by treatment approach 

Follow-Up Care After Treatment

Regular follow-up after vaginal cancer treatment is essential — typically involving pelvic examination and vault cytology at defined intervals, with imaging as clinically indicated. Patients are counselled about managing radiation side effects, including vaginal stenosis, which can be mitigated with vaginal dilators and appropriate specialist support. Palliative care and psychosocial support services complement clinical follow-up.