UK Vaginal Cancer incidence statistics

A diagram of the site of the vagina is shown in Figure 1.1

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Cancer of the vagina is rare with 252 new cases diagnosed in 2006. ( Table 1.1). 1-,4 This gives a European age-standardised incidence rate for vaginal cancer of 0.6 per 100,000 female population. 1-,4

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Cancer of the vagina accounts for less than 1% of all cancer cases (excluding non-melanoma skin cancer  NMSC) and less than 2% of gynaecological cancers in the UK.

The incidence of vaginal cancer increases with age. Rates are less than 0.5 per 100,000 females under 45, around 1 for women aged 45-64, rising to almost 3 per 100,000 in women over 65 ( Figure 1.2). 1-,4

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The incidence of vaginal cancer has remained stable in Britain over the last 25 years. The age-standardised rate has stayed at around 0.6 per 100,000 females ( Figure 1.3). 1-,4

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Figure 1.4 shows the vaginal cancer incidence trend for the UK.

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Each year an estimated 13,200 women are diagnosed with vaginal cancer worldwide. 5 Rates vary from about 0.2 per 100,000 females in eastern and western Asia to about 0.7 per 100,000 females in southern Asia and the Caribbean ( Figure 1.4). 5

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Higher rates of vaginal cancer reflect high levels of HPV infection, but probably also a lack of cervical screening programmes, which can pick up pre-cancerous lesions in the vagina.

Several case-control studies have reported an increased risk of vaginal cancer associated with lower socio-economic status and fewer years of education. 6-,12

More than 90% of primary tumours in the vagina are carcinomas, and, of these, almost 80% are squamous cell carcinoma and about 14% are adenocarcinomas. 13,14. Adenocarcinomas are more common in childhood and early adulthood, accounting for the vast majority of carcinomas diagnosed in women under 20. 13,14 A small proportion of adenocarcinomas are clear cell carcinomas arising in women exposed to diethylstilboestrol (DES) in utero (see Risk factors). The highest incidence of clear cell carcinoma arises in young women in their late teens and early 20s. 15 Melanomas and sarcomas account for about 7% of primary vaginal tumours. 13

A substantial proportion of vaginal invasive tumours are found with adjacent evidence of pre-cancers, known collectively as vaginal intraepithelial neoplasia (VAIN).

VAIN - caused by infection with HPV - is most frequently found in the upper third of the vagina, often with concomitant vulval or cervicallesions. Progression rates of treated VAIN of 2-5% have been reported, although these rates vary according to treatment used (see Symptoms and treatment). 16,17