In most cases, noticing any signs and symptoms of endometrial cancer, such as abnormal vaginal bleeding or discharge, and reporting them right away to your doctor allows the disease to be diagnosed at an early stage. Early detection improves the chances that your cancer will be treated successfully. But some endometrial cancers may reach an advanced stage before signs and symptoms can be noticed. More information about the signs and symptoms of endometrial cancer can be found in the section, "How is endometrial cancer diagnosed?"

Early detection tests

Early detection refers to testing to find a disease such as cancer in people who do not have symptoms of that disease.

Women at average endometrial cancer risk

At this time, there are no tests or exams that can find endometrial cancer early in women who are at average endometrial cancer risk and have no symptoms.

The American Cancer Society recommends that, at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer and strongly encouraged to report any vaginal bleeding or spotting to their doctor.

Women should talk to their doctors about getting regular pelvic exams. A pelvic exam can find some cancers, including some advanced uterine cancers, but it is not very effective in finding early endometrial cancers.

The Pap test (or Pap smear) can find some early endometrial cancers, but it is not used to look for endometrial cancer because it is not a good screening test for this type of cancer. The Pap test is very effective in finding early cancers of the cervix (the lower part of the uterus). For this reason, the American Cancer Society recommends that:

• All women begin cervical cancer screening about 3 years after they begin having vaginal intercourse, but no later than when they are 21 years old. Screening should be done every year with the regular Pap test or every 2 years using the liquid-based Pap test.

• Beginning at age 30, women who have had three normal test results in a row may get screened every two to three years. Another reasonable option for women over 30 is to get tested every three years (but not more often) with either the regular Pap test or the liquid-based Pap test, plus the HPV DNA test. Women who have certain risk factors such as diethylstilbestrol (DES) exposure before birth, HIV infection, or a weakened immune system due to organ transplant, chemotherapy, or chronic steroid use should continue to be screened annually.

• Women 70 years of age or older who have had 3 or more normal Pap tests in a row and no abnormal Pap test results in the last ten years may choose to stop having cervical cancer screening. Women with a history of cervical cancer, DES exposure before birth, HIV infection, or a weakened immune system should continue to have screening as long as they are in good health.

• Women who have had a total hysterectomy (removal of the uterus and cervix) may also choose to stop having cervical cancer screening, unless the surgery was done as a treatment for cervical cancer or pre-cancer. Women who have had a hysterectomy without removal of the cervix should continue to follow the guidelines above.

Women at increased endometrial cancer risk

The American Cancer Society recommends that most women at increased risk should be informed of their risk and advised to see their doctor whenever there is any abnormal vaginal bleeding. This includes women whose risk of endometrial cancer is increased due to increasing age, late menopause, never giving birth, infertility, obesity, diabetes, high blood pressure, estrogen treatment, or tamoxifen therapy.

Women who have (or may have) hereditary nonpolyposis colon cancer (HNPCC) have a very high risk of endometrial cancer. These women should be offered yearly testing for endometrial cancer with endometrial biopsy beginning at age 35. This includes women known to carry HNPCC-linked gene mutations, women who are likely to carry such a mutation (those with a mutation known to be present in the family), and women from families with a tendency to get colon cancer where genetic testing has not been done.

Another option for a woman who has (or may have) HNPCC would be to have a hysterectomy once she is finished having children. One study found that none of 61 women who had prophylactic hysterectomies developed endometrial cancer, while 1/3 of the women who didn't have the surgery did get endometrial cancer.

Last Medical Review: 10/22/2009
Last Revised: 10/22/2009