Uterine cancer is cancer that starts in the uterus. Most uterine cancers occur in people who have gone through or are going through menopause.

The uterus is a pear-shaped organ where a fetus grows during pregnancy. It is also known as the womb.

Anyone with a uterus can get uterine cancer. If a person has had surgery to remove their uterus, known as a hysterectomy, they cannot get uterine cancer.

The American Cancer Society estimates that in 2023, doctors will diagnose around 66,200 new cases of uterine cancer in the United States, and about 13,030 people will die from the condition.

This article discusses the causes and symptoms of uterine cancer. It also examines the types and stages of the disease and how doctors diagnose and treat it.

Doctor performing a hysteroscopy on a femaleShare on Pinterest
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Symptoms of uterine cancer may include:

These symptoms do not necessarily mean a person has uterine cancer. However, a person should speak with a doctor about any bleeding that is not typical for them to rule out uterine cancer and other conditions.

Doctors do not know the exact cause of uterine cancer.

However, high levels of the hormone estrogen may play a role in uterine cancer development.

High estrogen levels may cause changes, or mutations, in the DNA of cells in the uterus lining, called the endometrium.

Mutations transform healthy cells into abnormal cells that multiply out of control and live too long. These abnormal cancer cells can accumulate into a mass, or tumor, and spread to nearby tissues or elsewhere in the body.

Doctors cannot predict whether a person will get uterine cancer. Some people without an increased risk may still develop the cancer.

However, factors that may increase a person’s risk of developing uterine cancer include:

  • Hormone changes: The ovaries make the hormones estrogen and progesterone. Imbalances of these hormones may cause endometrium changes. Conditions that increase estrogen but not progesterone can also increase the risk of uterine cancer.
  • Menstruation years: Starting menstruation early or going through menopause later may increase uterine cancer risk. This is because the more periods a person has, the longer the endometrium’s exposure to estrogen.
  • Never being pregnant: During pregnancy, the body may make more progesterone than estrogen, so more pregnancies may help protect against uterine cancer.
  • Older age: People over 50 years are more likely to develop uterine cancer. It occurs more frequently among people who have gone through menopause.
  • Hormone replacement therapy (HRT): Some types of HRT containing estrogen but not progesterone raise uterine cancer risk.
  • Polycystic ovary syndrome (PCOS): PCOS occurs when an imbalance of reproductive hormones causes ovarian problems. The ovaries release an egg each month as part of the menstrual cycle. In people with PCOS, the egg may not develop correctly, or the ovaries may not release it during ovulation. PCOS may increase uterine cancer risk due to prolonged exposure of the endometrium to estrogen.
  • Breast cancer treatment: Tamoxifen helps treat and prevent breast cancer by blocking estrogen in breast tissue. However, tamoxifen acts like estrogen in the uterus, causing the uterine lining to grow and increasing uterine cancer risk among people who have gone through menopause. The benefits of using tamoxifen typically outweigh the risks, however.
  • A family history of bowel, ovarian, or uterine cancer: Uterine cancer tends to run in some families. These families may have a higher rate of only uterine cancer, or they may also have a higher risk of colon and ovarian cancer, a disorder called hereditary nonpolyposis colon cancer (HNPCC), also known as Lynch syndrome. People with HNPCC have a gene defect that reduces the body’s ability to repair DNA damage or control cell growth, resulting in a high risk of colon, ovarian, and uterine cancer.
  • Diabetes: Diabetes can increase a person’s risk of developing uterine cancer. A 2019 systemic review found that females with diabetes have a 72% higher risk of uterine cancer than those without diabetes.

There are two main types of uterine cancer: endometrial cancer and uterine sarcoma.

Endometrial cancer starts in the endometrium. It is the most common uterine cancer and is often treatable.

Uterine sarcoma starts in the smooth muscle layer of the uterus, called the myometrium, or the supporting connective tissue of the uterus.

Uterine sarcoma is rare. It is often more aggressive than endometrial cancer and challenging to treat.

After receiving a uterine cancer diagnosis, doctors determine whether it has spread and, if so, how far. Doctors call this process staging. Staging helps healthcare professionals decide how to treat cancer and determine the effectiveness of the treatment.

Healthcare professionals stage uterine cancer on a 1–4 scale. Doctors describe each stage as follows:

  • Stage 1: Cancer is in the uterus only.
  • Stage 2: Cancer may have spread to the cervical connective tissue but not beyond the uterus.
  • Stage 3: Cancer may have spread beyond the uterus and cervix but not outside the pelvis.
  • Stage 4: Cancer has spread beyond the pelvis to nearby or distant organs.

Doctors may use the following tests and procedures to help them diagnose uterine cancer:

If doctors suspect advanced cancer, they will order other tests to check for cancer spread, such as:

  • chest X-ray
  • CT scan
  • MRI scan
  • PET scan
  • cystoscopy
  • proctoscopy
  • blood tests

Gynecologists diagnose and treat diseases of the female reproductive system. Specialist doctors called gynecologic oncologists typically treat cancers of the uterus and other female reproductive organs.

Doctors may recommend the following treatments for uterine cancer:

  • Surgery: Surgery is the most common treatment for uterine cancer. A surgeon may remove the uterus, fallopian tubes, and ovaries and look for signs of cancer spreading during surgery. They may also remove lymph nodes for testing.
  • Radiation therapy: This therapy uses high energy beams to kill cancer cells or prevent them from growing. Doctors may recommend radiation therapy to reduce the chances of cancer returning after surgery or shrink a tumor before surgery to make removing it easier.
  • Chemotherapy: This cancer treatment uses drugs to stop cancer cell growth by killing the cells or preventing them from dividing. Doctors may use chemotherapy after surgery to help prevent cancer recurrence. They may also use it before surgery to shrink the tumor or to treat advanced cancer that has spread beyond the uterus.
  • Hormone therapy: Hormone therapy lowers hormone levels in the body. This therapy can kill cancer cells that rely on hormones to help them grow.
  • Targeted drug therapy: This treatment uses targeted drugs to identify and attack specific cancer cells. Doctors often combine targeted drug therapy with chemotherapy to treat advanced uterine cancer.
  • Immunotherapy: This treatment uses drugs to help a person’s immune system recognize and kill cancer cells. A doctor may consider immunotherapy when other treatments are unsuccessful.

The 5-year relative survival rate for all stages of endometrial cancer combined is 84%, according to the American Cancer Society. This means people with endometrial cancer are approximately 84% as likely as those without that cancer to live for at least 5 years after diagnosis.

This is only an estimate. Many factors influence a person’s outlook. Furthermore, treatments improve over time, giving people a better outlook than the numbers may indicate.

Anyone experiencing unusual vaginal spotting, bleeding, and discharge should contact a healthcare professional for advice, particularly if they have gone through menopause.

There are two main types of uterine cancer: endometrial cancer and uterine sarcoma.

People with uterine cancer may experience abnormal vaginal bleeding, such as changes to periods, bleeding between periods, or spotting or bleeding after menopause.

The exact cause of uterine cancer is unclear. However, high estrogen levels may play a role in disease development.

The first-line treatment for uterine cancer is surgery to remove the uterus, fallopian tubes, and ovaries. People may also receive radiation therapy or chemotherapy after surgery to reduce the risk of cancer recurrence.