Vulvar Cancer Screening and Diagnosis

Page Contents

Screening tests check for a condition, like cancer, in people who don’t have any signs or symptoms. There aren’t any screening tests for vulvar cancer. The best ways to detect this disease as early as possible are to get regular pelvic exams, even if everything seems fine, and see your primary care provider or gynecologist if you have any signs or symptoms that concern you.

When vulvar cancer is detected early it’s more likely to be cured.

Take Charge of Your Health

Talk to your primary care provider if you have symptoms that you think may be vulvar cancer. UW Medicine Primary Care can help you get started with screening. Learn about Fred Hutch's relationship with UW Medicine.

History and Exam for Vulvar Cancer

If you have signs or symptoms that could indicate vulvar cancer (or another problem with your reproductive organs), your provider will ask you about your symptoms, your health history and your family history. They may ask about factors that might put you at risk for cancer or other conditions that might cause the same symptoms.

Then, they’ll examine you to check for clues about what’s been bothering you. They will probably do a general physical exam and then a pelvic exam. This includes looking at the vulva for anything out of the ordinary.

Based on your conversation and exam, your provider may order tests to get more information.

Tests for Vulvar Cancer

As part of a pelvic exam, you may have a Pap test to check cells from your cervix and vagina and a test for human papillomavirus (HPV). HPV increases the risk for vulvar cancer, cervical cancer and other cancers. To diagnose vulvar cancer, physicians have to remove a small sample of tissue from your vulva and look at the cells under a microscope. This is called a biopsy.

Vulvoscopy and Biopsy of the Vulva

As part of your work-up, your provider may use a tool called a colposcope to look carefully at the skin of your vulva. The tool has a magnifying lens. This procedure is called vulvoscopy. To help abnormal cells stand out, the provider may apply a small amount of liquid (either diluted acetic acid, which is a type of vinegar, or dye) to the part of your skin they’re concerned about.

If the provider sees abnormal cells that need to be tested, they’ll give you numbing medicine in that area. Then they’ll collect some cells. They might use a scalpel to remove a small patch of skin (excisional biopsy). Or they might use a different tool to take a small sample from a larger abnormal area (punch biopsy).

Imaging Studies for Vulvar Cancer

The only way to tell whether you have vulvar cancer is to examine samples of tissue. In certain situations, your provider may also want you to have imaging studies as part of the diagnosis process. These could give your team more information, such as whether your cancer has spread. Imaging might include a computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or other scans. 

Dr. Barbara Goff
Dr. Barbara Goff is a Fred Hutch gynecologic oncologist and chair of Department of Obstetrics & Gynecology at UW Medicine.

Why Choose Fred Hutch for Vulvar Cancer Care

When you choose Fred Hutch Cancer Center for care, our experts confirm your vulvar cancer diagnosis. Before your first visit, your care team will review your pathology slides (tissue samples from biopsies) and any scans or tests you have already had. We have a dedicated pathologist who specializes in diagnosing gynecologic cancers. If needed, we will do further tests on your tissue sample.

During your first visit, you’ll see your gynecologic oncologist, who will ask about your medical history and symptoms and do an exam. Then, you’ll meet with the oncologist and other members of your care team to talk about what we found and what we recommend for you.

After your initial consultation, we’ll work with you so you can receive some of your treatment in your community, if you prefer.

“Once we evaluate the patient and establish their treatment strategy, we frequently partner with community oncologists to provide care closer to home,” said gynecologic oncologist Barbara Goff, MD. “This is especially helpful for patients who live outside the Seattle area.”

Vulvar Cancer Screening and Diagnosis FAQ

The provider who is doing your procedure will let you know if you need to do anything to prepare. For example, if you take medicines that thin your blood or prevent clotting, they might recommend stopping these for a few days before the procedure.

For a vulvar biopsy, you will lie on your back on an exam table with your feet in stirrups, like for a pelvic exam. Before the provider removes cells from your vulva, they will give you numbing medicine so you won’t feel any pain. This will be an injection (local anesthetic) near cells they plan to remove. They might rub a numbing cream on your skin (topical anesthetic) before the injection. If you have an excisional biopsy, you will have stitches (typically just one or two) to close the incision.

You may have minor discomfort when getting the anesthetic injection. You might have a little bleeding and soreness at the biopsy site for a few days. As with many minor procedures, there is a small risk of infection. Your care team may give you guidelines about the best ways to keep the area clean while it heals and things you should avoid for a while (like sitting in a hot bath if you have stitches). They will do everything they can to reduce the risks, and they’ll let you know what to watch for.

The time it takes for results may depend on which tests the pathologist needs to run. Tests may take from a few days to a week or more. After tests are done, the pathologist will write a report saying what they found. When you go in for your biopsy, ask your care team how long it will take to get results in your case.