Kevin Lutz, MD, FACP
Jan 1 2020

Endometrial cancer is the most common cancer of the reproductive organs among women in the United States. It can often be cured, especially when diagnosed early.

CancerWomen’s Health

What is Endometrial Cancer?

The terms “endometrial cancer” and “uterine cancer” are sometimes used interchangeably, but they don’t mean exactly the same thing. Endometrial cancer develops from a specific part of the uterus, the endometrium, which is the inner lining of the uterus. Most uterine cancers, more than 95%, start in the endometrium.

Endometrial cancer is the most common cancer of the reproductive organs among women in the United States. It can often be cured, especially when diagnosed early. Most women with endometrial cancer are diagnosed after menopause, although some women develop the disease earlier.

What are some symptoms of Endometrial Cancer? 

Most women with endometrial cancer have early symptoms. The most common symptom of endometrial cancer is abnormal uterine bleeding. For women who are premenopausal, this includes irregular menstrual bleeding, spotting and bleeding between menstrual periods. For women who are postmenopausal, any bleeding is abnormal. Symptoms of advanced endometrial cancer include abdominal or pelvic pain, bloating, feeling full quickly when eating, and changes in bowel or bladder habits.

What are the risk factors for Endometrial Cancer?

  • Most cases of endometrial cancer are diagnosed in women who are past menopause and are in their mid-60s.
  • The levels of estrogen and progesterone in a woman’s body can affect her risk of endometrial cancer. When estrogen is present without enough progesterone, it can cause the endometrium to become too thick. This condition can occur in women with irregular menstrual periods, during perimenopause and menopause, and with certain medical disorders, such as polycystic ovary syndrome. It also can occur in women who have a uterus who use estrogen-only therapy to treat menopause symptoms.
  • Having a body mass index (BMI) of 25 or greater is a major risk factor for endometrial cancer. As BMI increases, so does the risk of cancer.
  • Lynch syndrome is an inherited condition that increases the risk of colon cancer, ovarian cancer, endometrial cancer, and other types of cancer. It is caused by a change or mutation in a gene that is passed down in families. 
  • More years of menstruation. Starting menstruation at an early age (before age 12) or beginning menopause later increases the risk of endometrial cancer. The more periods a woman has had, the more exposure the endometrium has had to estrogen.
  • Never having been pregnant. If a woman has never been pregnant, she has a higher risk of endometrial cancer than someone who has had at least one pregnancy.
  • Using tamoxifen to prevent or treat breast cancer.

How is Endometrial Cancer diagnosed?

There are no screening tests to detect endometrial cancer in women with no symptoms. If a woman is postmenopausal, any abnormal bleeding needs to be checked. An ultrasound exam might be the first step. During this exam, the thickness of the endometrium and the size of the uterus are measured. A thickened endometrium (more than 4 mm) means that more testing is needed. The standard way that endometrial cancer is diagnosed is with an endometrial biopsy. In this procedure, a sample of the endometrium is removed and looked at under a microscope.

How is Endometrial Cancer treated?

Endometrial cancer is highly curable. Surgery is the first treatment for almost all women with endometrial cancer. The operation includes removing the uterus, fallopian tubes, and ovaries, this is called a total hysterectomy / bilateral salpingo-oophorectomy or TH/BSO. Lymph nodes and other tissue may be removed and tested to find out if they contain cancer. After surgery, the stage of disease is determined. The stage of cancer affects the treatment and outcome.

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