Vaginal cancer can develop after a hysterectomy for a benign or malignant condition. People who have received treatment for cervical cancers or precancers have a higher risk.

Vaginal cancer is a rare type of cancer. According to the American Cancer Society, vaginal cancer only makes up 1% to 2% of all cancers of the female reproductive tract.

A hysterectomy involves the surgical removal of the uterus. It may be done for benign (noncancerous) or malignant (cancerous) conditions.

It’s possible to get vaginal cancer after a hysterectomy.

This article looks at the risk of vaginal cancer after a hysterectomy and the symptoms to be aware of. Keep reading to learn more.

What is a hysterectomy?

A hysterectomy is a surgical procedure that removes the uterus. There are different types of hysterectomy:

  • Total hysterectomy: Both the uterus and the cervix are removed. This is the most common type of hysterectomy.
  • Supracervical hysterectomy: Only the upper portion of the uterus is removed.
  • Radical hysterectomy: The uterus, cervix, upper part of the vagina, and some of the surrounding tissues are removed.

Depending on why a hysterectomy is being done, a surgeon may remove other structures as well, including the:

Learn more about hysterectomy.

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A hysterectomy may help treat several types of benign (noncancerous) conditions. Some examples include:

You can get vaginal cancer after a hysterectomy for a benign condition. However, this is very rare. Not much is known about its likelihood and risk factors.

A 2024 review investigating this topic only included 56 people with vaginal cancer after a hysterectomy for a benign condition. Researchers found that most of these vaginal cancers:

  • were squamous cell cancers, which form in the flat, thin cells that line the vagina
  • happened around 10 years after the hysterectomy
  • occurred in the upper half of the vagina

A 2021 review notes that there’s currently no evidence to support routine screening for vaginal cancer if you’ve had a hysterectomy for a benign condition.

Can you get cervical cancer if you have no cervix?

Yes, it’s possible to have cervical cancer even if you have no cervix. This could happen if precancerous or cancerous cells had spread outside of your cervix before the hysterectomy.

For example, a study from 1980 found that roughly 18% of people had a recurrence of their cervical cancer after a radical hysterectomy, which involves the removal of the cervix.

A much more recent study from 2013 reported the recurrence rate of cervical cancer after a radical hysterectomy to be between 10% and 20%.

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Hysterectomy is also sometimes part of the treatment for cancers affecting the female reproductive tract, such as:

You can also get vaginal cancer if you’ve had a hysterectomy for a malignant (cancerous) condition.

Vaginal cancers after hysterectomy for a malignant condition often involve a treatment for cervical cancers or precancers called cervical intraepithelial neoplasia (CIN).

In fact, having had cervical cancer or CIN treatment is a risk factor for developing vaginal cancer. This makes sense because these cancers share risk factors like HPV infection and smoking.

An early 2013 study included 147 people who had had a hysterectomy for cervical cancer. Researchers followed up with them for an average of 43.3 months. They found that:

  • Twenty-two people (15%) had developed a vaginal precancer, called vaginal intraepithelial neoplasia (VAIN), or a recurrence of their cervical cancer after their hysterectomy.
  • All individuals with high grade VAIN or a recurrence had been treated for cervical squamous cell cancer.
  • VAINs and recurrences were found within 2 years of hysterectomy.

A 2021 study found that people with a prior history of CIN were more likely to develop VAIN or squamous cell cancer after a hysterectomy.

A 2020 study supports these findings and suggests that increased surveillance for vaginal cancers be offered for those who had CIN at the time of their hysterectomy.

Some of the potential symptoms of vaginal cancer after a hysterectomy include:

It’s also possible to have vaginal cancer and not have any noticeable symptoms. Up to 20% of people with vaginal cancer may be asymptomatic (no symptoms present). These cancers are often found during a routine pelvic exam or cervical cancer follow-up.

When should you see a doctor?

It’s important to visit a doctor if you have symptoms of vaginal cancer, especially if they’re persistent, recurring, or severe.

Vaginal cancer is rare, whether or not you’ve had a hysterectomy. Even if your symptoms aren’t due to vaginal cancer, they could be happening because of another condition that needs medical attention.

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There’s limited data on how having had a hysterectomy contributes to vaginal cancer outlook. A 2021 review notes that one of the most important factors for vaginal cancer outlook in general is the stage of the cancer at diagnosis.

A cancer’s stage reflects how far it has spread. A 2024 study including people with vaginal cancer after a hysterectomy for a benign condition found that 40% of vaginal cancers were stage 1. This is when the cancer is still only in the vagina.

This study only had follow-up data for 15 individuals. Of these, only two deaths were reported, with the remaining people still alive at the end of the follow-up period.

Other factors that can influence the outlook for vaginal cancer include:

  • the specific type of cancer
  • the size and location of the tumor
  • the tumor’s grade, which reflects how different cancer cells look from normal cells and can predict how aggressive the cancer is likely to be
  • the type of treatment used and how the cancer responds to it
  • your age and overall health

The American Cancer Society notes that the 5-year relative survival rates for vaginal cancer diagnosed between 2012 and 2018 were:

  • 69% when the cancer is only in the vagina
  • 57% if the cancer has spread into nearby tissues or lymph nodes
  • 26% if the cancer has spread distantly (metastasized)
  • 51% overall

It’s possible to get vaginal cancer after a hysterectomy. However, like vaginal cancer in general, this is very rare.

The main risk factor for developing vaginal cancer after a hysterectomy is having CIN treatment or cervical cancer. Both cervical and vaginal cancer share risk factors like HPV infection and smoking.

Even though vaginal cancer is rare, it’s important to talk with a doctor if you have symptoms like abnormal vaginal bleeding, abnormal vaginal discharge, or painful sex.

The outlook for vaginal cancer is best when it’s found and treated early.