Staging and grading of vulval cancer



The stage of a cancer is a term used to describe its size and whether it has spread beyond its original area of the body.

The grade of a cancer describes how quickly the tumour is likely to grow.

Knowing the extent of the cancer and the grade helps the doctors to decide on the most appropriate treatment.


If tests find vulval cancer, one of the following stages will be used to describe your cancer:

  • Stage 0 (carcinoma in situ): Abnormal cells are found on the surface of the vulval skin. These abnormal cells may become cancer and spread into nearby normal tissue.
  • Stage 1: Cancer is found only in the vulva and/or in the perineum, which is the space between the opening of the rectum and the vagina. The affected area is 2 cm or less in size.
  • Stage 2: Cancer is found in the vulva and/or the perineum. The affected area is larger than 2 cm.
  • Stage 3: Cancer is found in the vulva and/or perineum, and has spread to nearby tissues such as the lower part of the urethra (the tube through which urine passes), the vagina, the anus (the opening of the rectum) and/or nearby lymph nodes.
  • Stage 4: Cancer has spread beyond the urethra, vagina and anus into the lining of the bladder or the bowel, or it may have spread to the lymph nodes in the pelvis or to other parts of the body.
  • Recurrent: If the cancer comes back after initial treatment, this is known as recurrent cancer. Vulval cancer may come back in the vulva or in another part of the body.


A pathologist will use tests on your cancer biopsy to ‘grade’ your cancer. Grade refers to the extent of similarity of cancer cells to normal cells. Low-grade tumours tend to grow more slowly, whereas high-grade tumours grow faster and spread more quickly.