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Although cancer of the vagina is more common in postmenopausal women, an increase in young women being diagnosed with primary vaginal cancer has been reported, especially in countries with a high HIV prevalence. This is associated with persistence of high\u2010risk HPV infection. The emphasis should be on primary prevention with prophylactic HPV vaccination. Once there is a suspicion of a primary vaginal cancer, this should be confirmed histologically with biopsy. Staging has been done clinically, as with cervical cancer; however, there is a role for imaging in assisting with staging as this is often a difficult assessment. Treatment should be individualized and depends on stage as well as histologic subtype. It is prudent to refer cases to centers of excellence with experience in dealing with this rare gynecological cancer.<\/jats:p>","DOI":"10.1002\/ijgo.13867","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T13:09:29Z","timestamp":1634821769000},"page":"19-27","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":96,"title":["Cancer of the vagina: 2021 update"],"prefix":"10.1002","volume":"155","author":[{"given":"Tracey S.","family":"Adams","sequence":"first","affiliation":[{"name":"Department of Gynecological Oncology Groote Schuur Hospital University of Cape Town Cape Town South Africa"},{"name":"South African Medical Research Council University of Cape Town Gynecological Cancer Research Centre (SA MRC UCT GCRC) Cape Town South Africa"},{"name":"University of Cape Town Global Surgery Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda 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