Vaginal Cancer: Diagnosis

Approved by the Cancer.Net Editorial Board, 09/2023

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They do tests to learn if cancer has spread to a different part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

How vaginal cancer is diagnosed

There are different tests used for diagnosing vaginal cancer. Not all tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose vaginal cancer:

  • Pelvic examination. The doctor examines the vagina, the rest of the reproductive tract, bladder, and rectum to check for any unusual changes.

  • Pap test. During a Pap test, the doctor gently scrapes the outside of the cervix and vagina and takes a sample of cells for testing. During the test, you will usually feel some pressure as the doctor takes the sample of the cells, but there is usually no pain. Human papillomavirus (HPV) testing is usually part of the Pap test after age 29, based on guidelines from the American College of Obstetricians and Gynecologists (ACOG).

  • Colposcopy. The doctor may do a colposcopy to check the vagina and cervix for any abnormalities, especially when Pap or HPV tests return abnormal results. A colposcope is a special instrument, similar to a microscope, that magnifies the surface of the cervix and vagina. The colposcope gives the doctor a lighted, magnified view of the tissues of the vagina and the cervix. The colposcope is not inserted into the body. The examination is not painful, can be done in the doctor’s office, and has no side effects. This examination can be performed during pregnancy.

  • Biopsy. A biopsy is the only way to make a definite diagnosis, even if other tests can suggest that cancer is present. During biopsy, a small amount of tissue is removed for examination under a microscope. A pathologist analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The type of biopsy performed will depend on the location of the tissue being biopsied.

    If the biopsy indicates vaginal cancer, the doctor will refer the patient to a gynecologic oncologist, which is a doctor who specializes in treating gynecologic cancers. The specialist may suggest imaging tests to see if the cancer has spread beyond the vagina.

  • Ultrasound. An ultrasound creates a picture of the internal organs using sound waves.

  • Endoscopy. An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The person may be sedated as the tube is inserted through the mouth, anus, vagina, urethra, or a small surgical opening. Sedation is giving medication to become more relaxed, calm, or sleepy.

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail in the image. This dye can be injected into a patient’s vein or taken as a pill or liquid to swallow.

  • Magnetic resonance imaging (MRI). An MRI produces detailed images of the inside of the body using magnetic fields, not x-rays. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or taken as a pill or liquid to swallow.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is a way to create pictures of organs and tissues inside the body. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. Other conditions, such as infection or other causes of inflammation, can increase the uptake of the sugar as well. However, the amount of radiation in the substance is too low to be harmful. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results help the doctor describe extent of the cancer. This is called staging.

The next section in this guide is Stages. It explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.