Alfonzo E, et al. - Researchers conducted a population-based national cohort study to examine the risk of vaginal cancer among hysterectomised women with and without cervical intraepithelial neoplasia (CIN). Using national registries 1987–2011, they assessed all Swedish women, five million in total, aged 20 and up. Four exposure groups were formed of the study cohort: hysterectomised with no previous history of CIN3 and without prevalent CIN at hysterectomy; hysterectomised with a history of CIN3/adenocarcinoma in situ (AIS); hysterectomised with prevalent CIN at hysterectomy; non-hysterectomised. Vaginal cancer was reported in 898 cases. Incidence rates (IR) of vaginal cancer among women with prevalent CIN at hysterectomy and those with CIN3/AIS history were: 51.3 (34.3-76.5) and 17.1 (12.5-23-4) per 100,000, respectively. Based on outcomes, they recommend undertaking surveillance among hysterectomised women with prevalent CIN at surgery. They identified a more than doubled risk of contracting vaginal cancer among hysterectomised women without the studied risk factors vs non-hysterectomised women in the general population. However, the incidence rate does not justify screening.