Gynecological Cancers

Written by Stephanie Watson
Medically Reviewed by Traci C. Johnson, MD on February 28, 2025
10 min read

Gynecological cancers affect the reproductive organs of people who were assigned female at birth (AFAB). They include cancers of the:

  • Cervix
  • Ovaries
  • Uterus
  • Vagina
  • Vulva 

A sixth type is a very rare cancer of the fallopian tubes.

Each of these cancers has different symptoms, risk factors, and treatments. Learning the signs and symptoms is important. The earlier you get diagnosed and treated, the better your outlook. 

There are five main gynecological cancers. Each one starts in a different part of the reproductive system.

Cervical cancer

Cervical cancer begins in the cervix, the lower part of the uterus that attaches to the vagina. Most cervical cancers grow from squamous cells, which line the outer part of the cervix. This cancer is most often diagnosed when people are in their 30s or 40s. 

Deaths from cervical cancer have dropped by more than half since the 1970s, thanks to better screening. But disparities in treatment exist. Black Americans and Native American people are more likely to die from this cancer than White Americans.

Ovarian cancer

This cancer starts in the ovaries, the two glands on either side of the uterus that produce eggs and the hormones estrogen and progesterone. Ovarian cancer makes up about 1% of all cancers diagnosed in the United States. 

Rates of ovarian cancer have dropped over the last few decades. But ovarian cancer is still the deadliest gynecologic cancer because it's often diagnosed at a late stage.

Uterine cancer

This is the most common gynecologic cancer. It grows in the uterus, the organ where a fertilized egg implants and a baby develops. 

Most uterine cancers are endometrial cancers, which start in the endometrium, or lining of the uterus. Uterine sarcoma is a very rare type of uterine cancer that grows in the muscular wall of the uterus called the myometrium.

Uterine cancer usually starts after menopause. The average age at diagnosis is 60. Rates of this cancer have been increasing, especially in people of color. 

Vaginal cancer

This type starts in the vagina, which is the passageway from the cervix to the vulva. Vaginal cancer is rare. Only 1% to 2% of gynecologic cancers are this type. Most cancers in the vagina started somewhere else and then spread to the vagina. Vaginal cancer mainly affects people who are in their 60s or older. 

Vulvar cancer

Vulvar cancer grows from cells in the vulva, the outer part of the genitals that includes the clitoris and labia (lips). Vulvar cancer is very rare, making up less than 1% of all cancers in people AFAB. It mainly affects people ages 65 and older.

You know your body better than anyone else does. Call your doctor if you notice any of these symptoms.

Abnormal bleeding is a symptom of every gynecological cancer except vulvar cancer. The bleeding might look like:

  • Heavy periods
  • Spotting between periods
  • Bleeding after sex
  • Bleeding after menopause 

Missed periods can be a warning sign, too. "No bleeding for a prolonged period of time also should prompt a woman to see a doctor," says Rebecca Stone, MD, MS, a gynecologic oncologist at Johns Hopkins Medicine in Baltimore. 

Other symptoms differ by the type of cancer:

  • Bloating, feeling full quickly after eating, and belly or back pain can be signs of ovarian cancer.
  • Pain or pressure in the pelvis are signs of ovarian and uterine cancers.
  • An urgent need to pee, diarrhea, or constipation can signal ovarian and vaginal cancers.
  • Itching, burning, skin color changes, and sores on the vulva are symptoms of vulvar cancer.

Gynecologic cancers start when abnormal cells in the reproductive tract divide too quickly. Doctors don't know exactly what causes these cancers. A family history of gynecological cancers, as well as environmental factors like human papillomavirus (HPV) infection and hormone replacement therapy (HRT), might increase the risk.

A few things increase your risk of getting one of these cancers. But just because you have one or more of these risks doesn't mean you'll get gynecologic cancer. Some people who don't have any risks are diagnosed with one of these cancers.

Human papillomavirus (HPV)

This group of viruses causes almost all cases of cervical cancer and most vaginal and vulvar cancers. But most HPV infections go away on their own without causing cancer. Getting vaccinated can prevent many HPV-related cancers.

Genes

A family history and certain gene changes (mutations) increase the risk of gynecologic cancers. People who carry a BRCA1 or BRCA2 gene mutation are at a higher risk of ovarian cancer. Between 39% and 58% of women with the BRCA1 mutation, and 13% to 29% of those with the BRCA2 mutation will have ovarian cancer in their lifetime. An inherited condition called Lynch syndrome increases the risk of ovarian and uterine cancers.

Hormone replacement therapy (HRT)

HRT is a treatment for menopause symptoms like hot flashes and vaginal dryness. Estrogen-only HRT increases the risk of uterine cancer in people who still have a uterus. The longer you stay on hormone therapy, the higher your risk. Estrogen-only HRT is safe for anyone who's had a hysterectomy. If you have a uterus, your doctor will prescribe progesterone with estrogen to lower your uterine cancer risk.

Age

The risk of many of these cancers rises as you get older. For example, 60 is the average age when people are diagnosed with uterine cancer. The likelihood of getting vulvar or vaginal cancer also goes up once you reach your 60s.

These are some other things that are linked to an increased risk of gynecologic cancers:

  • Diabetes
  • High blood pressure
  • HIV and AIDS
  • Obesity
  • Smoking
  • Radiation to the pelvis
  • Starting your period before age 12 or going through menopause after age 55
  • Polycystic ovary syndrome (PCOS)

The diagnosis starts with a visit to a primary care doctor or obstetrician-gynecologist (OB/GYN). If your doctor suspects one of these cancers based on your symptoms, they can send you to a specialist called a gynecologic oncologist for more testing. 

"Doctors diagnose gynecological conditions using a combination of physical exams, imaging, and laboratory tests," says Radhika Gogoi, MD, PhD, a member of the Gynecologic Oncology Multidisciplinary Team at Karmanos Cancer Institute in Detroit.

Your doctor will first ask about your medical history and whether anyone in your family has been diagnosed with gynecologic cancer. They'll examine your cervix, uterus, ovaries, and fallopian tubes for any pain or growths.

These are some of the other tests doctors use to diagnose gynecological cancers:

  • Pap test. Your doctor sends a sample of cells from your cervix to a lab, where a pathologist looks at them under a microscope to see if they're cancer.
  • HPV test. It uses the same sample of cells from your Pap test to check for HPV, the virus that causes most cervical, vaginal, and vulvar cancers.
  • Imaging tests. Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) scans can show tumors and other noncancerous growths in your reproductive organs.
  • Biopsy. To confirm the diagnosis, your doctor will remove a small sample of tissue. A pathologist will check the sample under a microscope for signs of cancer.

You may need to visit more than one doctor to get the correct diagnosis. "If you're seeing a provider and you feel like you're not getting an answer or things don't make sense, then get a second opinion," Stone suggests.

Treatment depends on the type of cancer you have, its stage (where it has spread), and whether you want to have children in the future. Your doctor can talk you through the various treatment options, and explain their risks and benefits. 

Surgery

Surgery removes the cancer and some healthy tissue around it, or takes out the entire organ. These procedures treat gynecological cancers:

  • Hysterectomy removes the uterus and sometimes nearby lymph nodes to treat uterine and cervical cancers. A radical hysterectomy takes out the whole uterus, the tissues around the uterus, and the top part of the vagina.
  • Salpingo-oophorectomy takes out both ovaries and the fallopian tubes to treat ovarian cancer. It may be done with hysterectomy.
  • Omentectomy takes out the layer of fatty tissue that covers organs in the belly if the cancer has spread there.
  • Vaginectomy is surgery to remove part or all of the vagina. It's a treatment for vaginal cancer.
  • Vulvectomy takes out part or all of the vulva, and sometimes tissues around it, to treat vulvar cancer.
  • Laser ablation is a less-invasive procedure that uses a high-energy beam of light to burn off areas of cancer in the vagina and vulva.
  • Trachelectomy removes just the cervix, leaving the uterus intact. It's a less common treatment for cervical and vaginal cancers.

Chemotherapy

This treatment uses strong medicines to kill cancer cells and shrink tumors. You may get chemotherapy before surgery to shrink the tumor and make it easier to remove, or after surgery to lower the risk of the cancer coming back. You get these medicines through a vein (IV), by mouth, or directly into your belly. 

Radiation therapy

This treatment kills cancer with high-energy rays delivered from a machine (external-beam radiation therapy) or placed into your pelvis (brachytherapy). Radiation therapy also may be combined with other treatments, like surgery or chemotherapy.

Hormone therapy

Estrogen helps some types of ovarian cancers grow. Hormone therapy lowers estrogen levels in your body to treat the cancer.

Immunotherapy

This treatment helps your immune system become a better cancer fighter. Pembrolizumab (Keytruda) and dostarlimab (Jemperli) are immune checkpoint inhibitors. They block a protein called PD-1 on the surface of immune cells to help them mount a stronger attack against the cancer.

Targeted therapy

This treatment targets proteins and other things that help the cancer grow. These are some examples of targeted therapies for gynecological cancers:

  • Angiogenesis inhibitors like bevacizumab (Avastin) block the growth of new blood vessels that 'feed' tumors.
  • Poly (ADP-ribose) polymerase (PARP) inhibitors make it harder for ovarian cancer cells to fix their damaged DNA. It's a treatment for people who have a BRCA gene mutation.
  • Mirvetuximab soravtansine (Elahere) kills ovarian cancers with the folate receptor-alpha (FR-alpha) protein on their surface.
  • mTOR inhibitors like everolimus (Afinitor) and temsirolimus (Torisel) block a protein that helps cancer cells grow and divide.

Topical therapy

Fluorouracil (5-FU) and imiquimod (Aldara) are creams that you rub onto the area with cancer. 5-FU is a chemotherapy drug that treats vaginal and vulvar cancer. Imiquimod (Aldara) is a topical immunotherapy medicine.

Treatments for gynecological cancers can cause both short-term and long-term side effects. Short-term side effects should go away after you finish treatment. They include:

  • Pain when you pee
  • An urgent need to pee
  • Diarrhea
  • Tiredness
  • Skin redness or irritation 
  • No ovulation or periods

Long-term side effects stay with you months or years after you finish treatment. Sometimes they're permanent. The most common ones are:

  • Infertility
  • Early menopause
  • Vaginal dryness or narrowing
  • Diarrhea

You do have some control over your risk of these cancers. Here are a few things you can do to protect yourself:

Get vaccinated. The HPV vaccine may prevent more than 90% of cancers caused by HPV, including cervical, vaginal, and vulvar cancers. "It is most effective when given before exposure to HPV," says Gogoi. "It's typically recommended for preteens ages 9 to 12, but it's available for adults up to age 45 in some cases."

Keep up to date with screening tests. Pap and HPV tests detect cervical cancer or precancerous changes early, so you can get treated before the cancer has a chance to grow.

Ask about genetic screening. "Genetic counseling and testing for mutations like BRCA1, BRCA2, or Lynch syndrome can help assess risk and guide preventive measures for those with a family history of gynecologic or related cancers," says Gogoi.

Follow a healthy lifestyle. Eat a well-balanced diet rich in fruits, vegetables, and whole grains. Limit sugar and processed foods. Try to keep your weight within a healthy range. Don't smoke, and cut back on alcohol. These measures are good for your health in general, and they may lower your risk of cancer.

Consider preventive measures. If you're finished having children and are thinking about tubal ligation to prevent an unwanted pregnancy, consider salpingectomy instead. Removing the fallopian tubes might reduce the risk of ovarian cancer by as much as 80%. Taking birth control pills may reduce the risk of endometrial and ovarian cancers by 30% or more, although it can increase the risk of cervical and breast cancers.

Be alert for symptoms. Report any unusual bleeding, bloating, or other symptoms of gynecological cancers to your doctor right away.

There are five main types of gynecological cancer: cervical, ovarian, uterine, vaginal, and vulvar cancers. HPV infection, gene mutations, and conditions like obesity, HIV, and AIDS increase the risk of these cancers. Watch for symptoms like abnormal bleeding, bloating, and pain or pressure in your pelvis. Treatment for these cancers depends on the type and stage, but it can include surgery, chemotherapy, radiation therapy, immunotherapy, and targeted therapy. 

What is the most common gynecological cancer? Uterine cancer is the most common gynecologic cancer. About 69,000 people are diagnosed with this cancer each year.

Which is the deadliest gynecologic cancer? Ovarian cancer is the deadliest gynecologic cancer, mainly because it's often diagnosed at a late stage when it has already spread.

What is the hardest gynecological cancer to detect? Also ovarian cancer. Doctors don't have any screening tests for it, the way they do for cervical cancer. "It's probably the cancer that has one of the biggest delays in diagnosis," says Stone.