Uterine Cancer: A Complete Guide
From prevention to symptoms, diagnosis and treatment
- Uterine cancer most often starts in the endometrium, the inner lining of the uterus (womb).
- Bleeding or spotting after menopause does not always mean cancer, but it should be checked by a doctor, even if it is light or happens only once.
- A Pap test (Pap smear; in the UK, a smear test) does not screen for cancer of the body of the uterus.
Find your starting point:
- If you have abnormal bleeding or an abnormal test result, start with the Uterine cancer diagnosis page.
- If cancer has been confirmed, read the Uterine cancer treatment page.
- To learn about risk factors and how to lower them, see the Uterine cancer prevention page.
Video in Persian
What is uterine cancer, and what are the signs?
What is uterine cancer?
Most uterine cancers start in the endometrium, the inner lining of the uterus, and are called “endometrial cancer”. Rarer types can start in the muscle or other tissues of the uterus.
Abnormal bleeding is the most important symptom of endometrial cancer. In more than 90% of women who have this cancer after menopause, vaginal bleeding is the first symptom. Still, not all bleeding after menopause means cancer.
Who is at higher risk?
Getting older, being overweight or having obesity, taking estrogen without progesterone if you have a uterus, and taking tamoxifen can raise the risk of endometrial cancer. A family history of uterine cancer, or certain inherited conditions such as Lynch syndrome, also affect the risk.
How is uterine cancer different from cervical and ovarian cancer?
The main difference is where the cancer starts: the body of the uterus, the cervix or the ovary.
They are also checked and treated in different ways. A Pap test looks for cell changes in the cervix, and a normal Pap result does not rule out uterine or ovarian cancer.
Can uterine cancer be treated?
Yes, uterine cancer can be treated, and many cases of endometrial cancer are treated successfully, especially at early stages. The choice of treatment and its outcome depend on the type of cancer, the stage and the person’s situation. To learn about the options, read the Uterine cancer treatment page.
The difference between uterine and cervical cancer
Uterine (endometrial) cancer
It starts in the inner lining of the uterus, and its most common symptom is abnormal bleeding. Checks may include a transvaginal (internal) ultrasound and an endometrial biopsy. The diagnosis is confirmed by examining a tissue sample.
Cervical cancer
It starts in the lower part of the uterus, the cervix, and most cases are linked to a persistent high-risk HPV (human papillomavirus) infection. Screening is done with an HPV test, a Pap test or both together (co-testing). Depending on the result, a colposcopy and a biopsy may be needed.
There is no routine screening test for uterine cancer. The Pap test is for the cervix.
- Any bleeding or spotting after menopause, however small
- Spotting between periods, bleeding during or after sex, or unusually heavy periods
- Unusual vaginal discharge or ongoing pelvic pain
These symptoms do not necessarily mean cancer, but they should be checked. Uterine cancer can also happen before menopause, so talk to your doctor about abnormal bleeding at any age.
Choosing the best path for your situation
Abnormal uterine bleeding or bleeding after menopause
Most abnormal bleeding is not caused by cancer, but bleeding after menopause should be checked.
Diagnostic tests for uterine cancer usually start after a symptom such as abnormal bleeding.
Endometrial thickness on your ultrasound report
The thickness of the endometrium on an ultrasound does not, on its own, confirm cancer.
This measurement is one of the pieces of information that help your doctor decide on further tests or a biopsy. It is read differently before and after menopause.
Your doctor has recommended an endometrial biopsy
The diagnosis is confirmed by examining a tissue sample. A biopsy does not mean removing the uterus.
If you are waiting for results: being sent for a biopsy does not mean you have been diagnosed with cancer. The result may be benign (not cancer), or it may show changes that need follow-up or treatment. When the result is ready, your doctor will look at it together with your symptoms and other findings and explain the next step.
Endometrial hyperplasia on your biopsy result
Endometrial hyperplasia means the inner lining of the uterus has overgrown. The type without atypia has a lower risk of turning into cancer, but it still needs follow-up and, in many cases, treatment.
The atypical type, meaning there are also abnormal cell changes, is a precancerous condition and needs treatment and close follow-up. With this type, the doctor also checks whether cancer may already be present at the same time.
For each of the situations above, you will find more detail on the diagnosis page.
Confirmed uterine cancer and choosing treatment
In most cases, the main treatment for uterine cancer is surgery, and treatment at early stages usually has better results.
Minimally invasive surgery is suitable for many patients. The type of operation depends on how far the cancer has spread and on each person’s situation.
After treatment: the follow-up plan depends on the risk of the cancer coming back and on the person’s situation. For low-risk endometrial cancer, an exam is usually done every 6 months for the first two years; for high-risk cancer, every 3 months for the first three years.
From anywhere in the world
Family history of uterine cancer or Lynch syndrome
A family history of uterine or colon cancer may mean that testing for Lynch syndrome and genetic counseling are needed.
Most cases are not inherited, but Lynch syndrome can raise the risk.
Frequently asked questions about uterine cancer
A gynecologist does the first assessment and refers you on if needed. Once cancer is confirmed, a gynecologic oncologist usually plans and oversees your treatment.
- Biopsy: In a biopsy, only a very small piece of the inner lining of the uterus is taken so the cells can be checked. This is completely different from surgery to remove the whole uterus (hysterectomy).
- Atypical hyperplasia: The definitive treatment is usually removing the uterus. For someone who wants to become pregnant, hormone treatment that keeps the uterus may be chosen, after checking whether cancer may be present at the same time. The response to treatment is checked with a repeat biopsy within 3 to 6 months.
- Early-stage cancer: For some patients with early, low-risk disease, keeping the uterus and fertility can be considered.
Good nutrition helps your body during treatment, but it does not replace medical treatment. If you take supplements or herbal remedies, tell your care team so they can check for possible interactions with your medicines.
Your questions
No question has been published on this page yet.
Ask the first one. The answer is published right here, under your question.
Write your question