Endometrial Cancer Screening

Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.

The endometrium is the innermost lining of the uterus. The uterus is a hollow, muscular organ in a woman's pelvis. The uterus is where a fetus grows. In most nonpregnant women, the uterus is about 3 inches long.

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Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium.

Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called uterine sarcoma. For more information, see Uterine Sarcoma Treatment.

For more information about endometrial cancer, see:

• Endometrial Cancer Treatment
• Endometrial Cancer Prevention

Endometrial cancer is most common in postmenopausal women.

Endometrial cancer is diagnosed most often in postmenopausal women at an average age of 60 years.

Since the mid-2000s, the number of new cases of endometrial cancer has increased slightly, with rates about 2% per year higher in women younger than 50 years and 1% per year higher in women aged 50 years and older. Between 2016 and 2020, death rates from endometrial cancer increased by slightly less than 1% per year.

Health history and certain medicines can affect the risk of developing endometrial cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for endometrial cancer include the following:

• Taking tamoxifen for treatment or prevention of breast cancer.
• Taking estrogen alone. (Taking estrogen in combination with progestin does not appear to increase the risk of endometrial cancer.)
• Being overweight.
• Eating a high-fat diet.
• Never giving birth.
• Beginning menstruation at an early age.
• Reaching menopause at an older age.
• Having the gene for hereditary non-polyposis colon cancer (HNPCC).
• Being a White individual.

Tests are used to screen for different types of cancer when a person does not have symptoms.

Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

Endometrial cancer is usually found early.

Endometrial cancer usually causes symptoms (such as vaginal bleeding) and is found at an early stage, when there is a good chance of recovery.

There is no standard or routine screening test for endometrial cancer.

Screening for endometrial cancer is under study and there are screening clinical trials taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI website.

Tests that may detect (find) endometrial cancer are being studied:

Transvaginal ultrasound

No studies have shown that screening by transvaginal ultrasound (TVU) lowers the number of deaths caused by endometrial cancer.

Transvaginal ultrasound (TVU) is a procedure used to examine the vagina, uterus, fallopian tubes, and bladder. It is also called endovaginal ultrasound. An ultrasound transducer (probe) is inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram.

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Transvaginal ultrasound. An ultrasound probe connected to a computer is inserted into the vagina and is gently moved to show different organs. The probe bounces sound waves off internal organs and tissues to make echoes that form a sonogram (computer picture).

TVU is commonly used to examine women who have abnormal vaginal bleeding. For women who have or are at risk for hereditary non-polyposis colon cancer, experts suggest yearly screening with transvaginal ultrasound, beginning as early as age 25.

The use of tamoxifen to treat or prevent breast cancer increases the risk of endometrial cancer. TVU is not useful in screening for endometrial cancer in women who take tamoxifen but do not have any symptoms of endometrial cancer. In women taking tamoxifen, TVU should be used in those who have vaginal bleeding.

Endometrial sampling is commonly used to examine women who have abnormal vaginal bleeding. If you have abnormal vaginal bleeding, check with your doctor.

Screening tests for endometrial cancer are being studied in clinical trials.

Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Screening tests have risks.

Decisions about screening tests can be difficult. Not all screening tests are helpful and most have risks. Before having any screening test, you may want to discuss the test with your doctor. It is important to know the risks of the test and whether it has been proven to reduce the risk of dying from cancer.

The risks of endometrial cancer screening tests include the following:

If you have any questions about your risk for endometrial cancer or the need for screening tests, check with your doctor.

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PDQ® Screening and Prevention Editorial Board. PDQ Endometrial Cancer Screening. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-screening-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389486]

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