Endometrial Cancer Endometrial cancer starts in the endometrium, the inner lining of the uterus. The uterus is a hollow organ about the size of a pear. It has two layers: the endometrium and the myometrium, an outer layer of muscle tissue.

View the Understanding Endometrial Cancer online brochure.

Risk Factors

Risk factors increase the odds of getting a disease but do not always mean a disease will occur. Endometrial cancer risk factors include the following:

• Many menstrual cycles: Menstruating before age 12 and/or going through menopause late in life raises endometrial cancer risk.
• Never pregnant: Pregnancy increases the hormone progesterone, preparing the endometrium to sustain a fertilized egg and reducing cancer risk.
• High-fat diet and obesity: Most estrogen is produced by the ovaries, but fat tissue can change other hormones into estrogen. This increase in estrogen raises endometrial cancer risk.
• Tamoxifen use: Although called an anti-estrogen drug and used to treat breast cancer, this drug acts like an estrogen in the uterus. It causes uterine lining to grow and increases endometrial cancer risk.
• Hormone replacement therapy (HRT): Using estrogen to offset the symptoms of menopause may increase endometrial cancer risk.
• Family history of colon cancer: Women at risk for hereditary nonpolyposis colon cancer are more likely to develop endometrial cancer.

Symptoms of Endometrial Cancer

Consult your doctor if any of the following problems are persistent:

• Bleeding or discharge not related to menstruation
• Difficult or painful urination
• Pain during sexual intercourse
• Pain in the pelvic area

If you have gone through menopause, it is especially important to report unusual vaginal bleeding, spotting, or discharge to your doctor.

Early Detection and Prevention

In the United States, endometrial cancer is the most common cancer of the female reproductive system. About 70% of all uterine cancers are found in women between the ages of 45 and 74, with the highest number diagnosed between 55 and 64. Only 8% occur in younger women.

Endometrial cancer is usually detected because a woman has symptoms. This cancer is hard to prevent and no screening tests are currently available, but certain lifestyle choices may lower risk:

• Pregnancy
• Use of oral contraceptives
• Controlling obesity and diabetes

Diagnosis of Endometrial Cancer

To diagnose endometrial cancer, a doctor removes a small amount of endometrial tissue for inspection under a microscope. This is done in two ways:

• Biopsy: A very thin, flexible tube is inserted into the uterus and a small amount of tissue is obtained. The test takes a minute or less with discomfort similar to menstrual cramps and can be done in a doctor’s office.
• Dilation and curettage (D & C): If the biopsy doesn’t provide enough tissue or if results are uncertain, a D & C is done. In this outpatient procedure, the cervix is dilated and a special instrument is used to obtain a tissue sample.

If you are diagnosed with endometrial cancer, consult a gynecologic oncologist. These specialists have advanced surgical and medical training in treating gynecologic cancers.

Staging and Treatment

Staging determines the extent of a cancer and if it has spread. Staging is very important because endometrial cancers have different prognoses and treatments based on stage. In addition to stage, treatment options depend on patient health, childbearing plans, and other considerations. Treatments include the following:

• Surgery
• Chemotherapy
• Radiation therapy
• Hormonal therapy

The patient and her cancer health care team will determine the best treatment options.