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Tests for Vaginal Cancer
Diagnosing vaginal cancer might involve physical exams, a Pap test, an HPV test, imaging, biopsy, or removal of a tumor. If you have any of the signs or symptoms of vaginal cancer, you should see a healthcare provider.
Medical history and physical exam
If you have signs or symptoms that could be caused by vaginal cancer, your healthcare team will get a medical history and do a physical exam.
The medical history will include questions about your symptoms and risk factors for vaginal cancer or other cancers that might spread to the vagina. For example, your care team might ask about:
- Your sexual history
- Any immune-suppressing medicines or infections such as HIV
- Smoking
- A family history of cancer
Pelvic exam
The exam will include a pelvic exam, which includes a few parts.
Speculum exam: The healthcare provider gently inserts a device, called a speculum, inside the vagina to look inside for abnormal areas. In some cases, a special magnifying tool called a colposcope is used to look more closely at any abnormal areas.
Bimanual exam: The healthcare provider places 2 gloved, lubricated fingers of one hand inside the vagina, while the other hand presses on the abdomen to check for any abnormalities of the pelvic organs, such as the uterus and ovaries. The healthcare provider might also examine your groin area for enlarged lymph nodes at this time.
Rectovaginal exam: The healthcare provider will place a gloved and lubricated finger in the vagina and another finger from the same hand in the rectum. The other hand presses down on the lower belly, allowing the healthcare provider to feel the tissue between the vagina and rectum for anything abnormal.
HPV test and Pap test
During HPV (human papillomavirus) and Pap tests (Pap smear), the healthcare provider gently collects samples from the cervix and vagina for testing. You will usually feel some pressure as the healthcare provider takes the sample of the cells, but there is not usually any pain.
Colposcopy
Your doctor might suggest you have a test called a colposcopy:
- If your pelvic exam reveals a concerning finding
- If your Pap test (a swab of cells from your cervix) shows abnormal cells
- If you test positive for HPV
Colposcopy is often done in the clinic and takes less than 20 minutes. You can go home the same day. Colposcopy is usually no more uncomfortable than any other speculum exam. You will lie on the exam table, and the healthcare provider will put a speculum in the vagina to help keep it open while examining the vagina and cervix with a colposcope.
The colposcope is an instrument that has magnifying lenses. It lets the healthcare provider clearly see the vaginal walls and cervix up close. A solution called acetic acid (much like vinegar) or iodine might be used to make any abnormal areas easier to see. This might cause mild discomfort, like a brief sting.
If an abnormal area is seen, a small piece of tissue will be removed (biopsied) and sent to a lab to be looked at carefully. A biopsy is the best way to tell for certain whether an abnormal area is a precancer, invasive cancer, or neither.
Colposcopy can be done safely even if you are pregnant. Like the Pap test, it is better not to do during your menstrual period.
Vaginal biopsy
Certain signs and symptoms might suggest vaginal cancer, but many of them can be caused by other problems. A biopsy is the only way to know whether any abnormal findings, such as a mass or ulcer, are cancer. In this procedure, a small piece of tissue from the suspicious area is removed and looked at under a microscope.
A vaginal biopsy can usually be done in a healthcare clinic using numbing medicine (local anesthesia). It only takes a few minutes.
In some cases, you might be put under general anesthesia (in a deep sleep) depending on the size of the abnormal area and any other procedures that might be needed.
If the biopsy shows vaginal cancer, your care team might refer you to a gynecologic oncologist, a doctor who specializes in treating gynecologic cancers.
Imaging tests
Imaging tests are used to create pictures of the inside of your body. Imaging tests might be done after a diagnosis of vaginal cancer to learn more about the cancer and see if it has spread.
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A plain x-ray of your chest might be done to see if the cancer has spread to your lungs.
A CT scan combines many x-ray pictures to make detailed, cross-sectional images of the soft tissues of your body.
CT scans might be used to see if cancer has spread from the vagina to other organs.
Sometimes, a contrast dye is given before the scan to show better details in the image. This dye can be injected into a vein (IV) or swallowed as a pill or liquid.
CT-guided needle biopsy: For this procedure, you remain on the CT scanning table while the doctor moves a biopsy needle through the skin and toward an abnormal area to remove a biopsy sample. This isn't done to biopsy vaginal tumors, but it might be used to biopsy possible sites of cancer spread (metastases).
MRI scans create detailed images of soft tissues inside your body. This is done using radio waves and strong magnets instead of x-rays, so there is no radiation.
MRI images can be useful in examining pelvic tumors. To get the most detailed images of a vaginal tumor, you might be asked to insert a vaginal gel before the pelvic MRI. This opens the vaginal canal, making a tumor easier to see.
MRI images are useful for showing the exact location and size of the vaginal tumor, as well as any enlarged lymph nodes in the groin. Sometimes a contrast dye might be given before the scan to create a clearer picture. This contrast dye is different from the contrast given during a CT scan.
For a PET scan, a slightly radioactive form of sugar, known as FDG, is injected into the blood and collects mainly in cancer cells. These areas of radioactivity can be seen on a PET scan using a special camera.
A PET scan can be used to find out if cancer has spread. PET and CT scans are most often done at the same time. This lets doctors compare areas of higher radioactivity on the PET scan with a more detailed picture of that area on the CT scan.
PET scans are not often used in women with early vaginal cancer, but they might be helpful in finding areas of cancer spread in more advanced cancers.
Endoscopic tests
These endoscopy procedures are not used often for people with vaginal cancer, but they might be needed in certain cases.
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Proctoscopy looks at the rectum. It’s done to check for spread of vaginal cancer. This test might be done if the vaginal cancer is large or in the part of the vagina next to the rectum.
This procedure uses a thin, flexible, lighted tube in the rectum. It allows the doctor to look closely for any cancer spread.
Any area that looks suspicious will be biopsied. This test might be somewhat uncomfortable, but it should not be painful.
Cystoscopy is a procedure done by a specialist in the female genital or urinary tract. It’s done to check for spread of vaginal cancer to the bladder. It might be recommended if a vaginal cancer is large or in the front wall of the vagina, near the bladder.
This procedure allows the doctor to look at the inside of the bladder with a cystoscope. This is a long, thin, flexible tube with light and a camera on the end. The cystoscope is inserted through the urethra and up into the bladder.
If suspicious areas or growths are seen during the test, a biopsy will be done.
- Written by
- 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).
Expert Panel on GYN and OB Imaging, Kilcoyne A, Gottumukkala RV, et al. ACR Appropriateness Criteria® Staging and Follow-up of Primary Vaginal Cancer. J Am Coll Radiol. 2021;18(11S):S442-S455.
Karam A, Berek JS, Kidd EA. Vaginal Cancer. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/vaginal-cancer on September 8, 2026.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Vaginal Cancer Version 2.2026 – December 4, 2025. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/vaginal.pdf on September 8, 2026.
Last Revised: October 23, 2026
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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