Know Your Endometrial Cancer Risk

Endometrial cancer is a type of cancer that starts in the lining of the uterus. It is the most common type of gynecologic cancer in the United States.

The endometrium (the layer of tissue that lines the uterus) grows every month to prepare for pregnancy. If there’s no pregnancy, the tissue sheds, resulting in menstruation. When cancer cells grow in the tissue, they cause endometrial cancer, also known as cancer of the uterine corpus.

Tina Ayeni, MD, gynecologic oncology specialist with Franciscan Physician Network Gynecologic Oncology in Indianapolis, shares insights on endometrial cancer, including risk factors, symptoms and the latest treatments.

How Common Is Endometrial Cancer?

The American Cancer Society estimates that in 2025, 69,120 women will be diagnosed with endometrial cancer, including 1,400 women in Indiana and 2,780 in Illinois.

Endometrial cancer can have symptoms similar to cervical and ovarian cancers. Sometimes endometrial cancer can be misdiagnosed as menstrual problems.

 There’s been a more than 2% annual increase in uterine cancer cases in the United States, partially due to increasing obesity rates among Americans, researchers said. Death rates also increased by more than 1% a year between 1999 and 2016.

What Are Risk Factors For Endometrial Cancer?

“Today, doctors have a good understanding of the risk factors associated with gynecologic cancers,” said Dr. Ayeni.

One of the most common causes of endometrial cancer is obesity and being overweight.

“Fat cells in the body make the hormone estrogen. Unfortunately, those cells also feed the endometrium, causing it to grow rapidly. “If you have unregulated, continuous growth, the normal cells can transition to pre-cancer and then to cancer cells,” said Dr. Ayeni. Additional risk factors for endometrial cancer include the following:

1. Age: Women between the age of 50 and 70
2. Diabetes: Women diagnosed with diabetes
3. Endometriosis: Women diagnosed with endometriosis
4. Genetics: Women with specific genetic mutations such as BRCA1 and BRCA2 genes and those who inherited Lynch syndrome and Cowden syndrome
5. Hormonal factors and hormone use: Women exposed to higher levels of estrogen over time and those who used hormone replacement therapy (HRT) for more than five years
6. Polycystic ovarian syndrome (PCOS): Women with PCOS who have abnormal hormone levels
7. Fertility challenges: Women who have difficulty getting pregnant
8. Tamoxifen use: Women who take tamoxifen to treat breast cancer
9. Smoking: Women who use tobacco.

What Are Common Signs Of Endometrial Cancer?

“The most common and early symptom of endometrial cancer is abnormal bleeding,” Dr. Ayeni said. “With endometrial cancer, women may notice they’re bleeding between their cycles instead of having a once-a-month menstrual cycle. This irregular pattern can also include much heavier cycles than the previous month.”

Any bleeding is abnormal for women in their post-menopause years who no longer have menstrual cycles. Though it’s not always a sign of cancer, you should discuss any abnormal bleeding with your gynecologist.

Other signs and symptoms of endometrial cancer include:

• Difficulty or pain when urinating
• Pain during intercourse
• Pain in the pelvic area

Endometrial cancer can have symptoms similar to cervical and ovarian cancers. Sometimes endometrial cancer can be misdiagnosed as menstrual problems.

Is There A Screening For Endometrial Cancer?

There’s no screening test for endometrial cancer, but the disease is frequently caught at an early stage because it has detectable symptoms like abnormal and postmenopausal bleeding.

How Is Endometrial Cancer Treated?

Treatments usually include one of three approaches: minimally invasive surgery, radiation or systemic treatment (medicine, including chemotherapy). With many gynecologic cancers, doctors may offer multiple treatment approaches. However, early-stage endometrial cancer can be different. “Many times, minimally invasive surgery is all you need. Sometimes we also recommend vaginal radiation after surgery,” Dr. Ayeni said. Vaginal radiation consists of three treatments, 15 minutes in length. And though rare, this treatment causes minimal side effects.

With more advanced endometrial cancer, doctors perform more invasive surgery, such as a hysterectomy, using the DaVinci® Robotic System or a standard laparoscopic approach. This surgery removes the uterus, ovaries and fallopian tubes.

The Importance Of Annual Check-Ups

A critical component of women’s health is an annual pelvic exam. However, Dr. Ayeni cautions that a yearly exam doesn’t necessarily include a Pap test. Generally, doctors recommend a Pap test every three to five years, depending on your age. However, depending on your gynecologic health history, Dr. Ayeni said, you may need a Pap test every year.

The one exam you do need every year is a female pelvic exam. Just as you would have other major organs evaluated, such as your heart or lungs, it’s important to assess your pelvic health.

“A doctor should assess the health of your vagina and bowels during an annual exam,” said Dr. Ayeni. “And as you age, that female pelvic exam should also include a rectal exam.”

Pelvic exams can assess for a lesion in the vagina, even when you aren’t experiencing symptoms. It can also determine if your cervix has shifted and is not sitting correctly. This misalignment can potentially indicate an issue with your ovaries. The annual pelvic exam helps your doctor screen for abnormalities, including endometrial cancer.

Are you experiencing abnormal gynecologic bleeding? If so, it’s essential to talk to your provider about your concerns and possible screening for endometrial cancer. When diagnosed at an early stage, endometrial cancer has a five-year survival rate of nearly 95%.

At Franciscan Health, our team is committed to compassionate care across every stage of women’s health. Our comprehensive women’s cancer team, including researchers, genetic counselors, survivorship specialists and nurse navigators, makes you our priority throughout all stages of life.