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Precancerous conditions of the vagina have the potential to develop into vaginal cancer. They are abnormal changes (called dysplasiadysplasiaAbnormal development, appearance and organization of cells so that they are different from normal cells in size, shape and organization within tissue. Dysplasia almost always refers to a precancerous condition.) that have taken place in the cells of the vagina. Over time, some of these precancerous changes can turn into cancer if left untreated. It may take many years (approximately 5–10 years) for precancerous conditions to progress to invasiveinvasive1. Referring to a procedure or device that breaks the skin or enters a body cavity. 2. Referring to a disease (such as cancer) that is growing into surrounding tissue or has spread outside the tissue where it started. vaginal cancer, but sometimes this can happen in less time.
VAIN is the most common precancerous condition of the vagina. Abnormal changes occur in the cells in the epithelium (inner surface layer) of the vagina. VAIN often occurs together with cervical intraepithelial neoplasiacervical intraepithelial neoplasiaAbnormal cells in the cervix (the lower, narrow part of the uterus, or womb) that can become cancerous. (CIN) and is thought to have a similar cause. VAIN is more often seen in the upper part of the vagina and is often multifocal (in more than one place). VAIN may extend from nearby areas of CIN or occur separately.
VAIN is categorized based on the severity of the abnormality in the epithelium:
The following risk factors may increase a woman’s chance of developing VAIN.
Precancerous changes in the vagina often do not cause any signs or symptoms.
An abnormal Pap test result is often the first sign that some cells in the cervix or vagina are abnormal. This is why it is important to have regular Pap tests and pelvic examinations.
If the doctor suspects a precancerous condition of the vagina, tests will be done to make a diagnosis. Tests may include:
Often, milder changes (VAIN I) return to normal without any treatment. The doctor will discuss whether repeating the Pap test later on and waiting to see if mild changes resolve on their own is an option. Moderate changes (VAIN II) likely won’t return to normal, so treatment is usually started right away. More severe abnormalities (VAIN III) are more likely to develop into invasive vaginal cancer, especially if they are not treated. It is hard to predict which of these will become invasive and which will not.
Treatment options for VAIN may include: