Know Your Endometrial Cancer Risk

Bleeding after menopause can be alarming. Even bleeding between periods may be easy to dismiss as hormonal changes. But these symptoms can sometimes be the earliest sign of endometrial cancer, which is why it's important to know your risk and when to talk with a gynecologist.

Dominic Schaut, DO, an OBGYN with Franciscan Physician Network Obstetrics & Gynecology Lafayette, shares insights on endometrial cancer, including risk factors, symptoms and the latest treatments.

Key Takeaways: Endometrial Cancer Risks & Symptoms

• Endometrial cancer is the most common gynecologic cancer in U.S. women. 
• Obesity and hormonal factors are major risk factors. Excess body fat increases estrogen production, which can stimulate the endometrial lining and lead to cancer development. Other risk factors include age (especially 50–70), diabetes, endometriosis, PCOS and certain genetic conditions like Lynch syndrome. 
• Abnormal bleeding is the most common early symptom of endometrial cancer. Women may notice irregular bleeding between periods or after menopause, and discussing these symptoms with a gynecologist can lead to early detection. 
• There’s no routine screening test, but early detection is common. Because symptoms like abnormal bleeding are often noticeable, endometrial cancer is frequently diagnosed at an early, highly treatable stage. 

What Is Endometrial Cancer?

Endometrial cancer is a type of cancer that starts in the lining of the uterus.

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.

How Common Is Endometrial Cancer?

Endometrial cancer is the most common type of gynecologic cancer in the United States. The American Cancer Society estimates that in 2026, 68,270 women will be diagnosed with endometrial cancer, including 1,420 women in Indiana.    

Endometrial cancer rates appear to have stabilized in recent years in white women but continue to increase in women of all other racial and ethnic groups by 2% or more per year. 

Am I At Risk For Endometrial Cancer?

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

Several factors contribute to a woman’s increased risk of ovarian cancer.

Weight

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. Schaut.

Genetics

Genetic changes can be passed down from a parent. Women with specific genetic mutations such as BRCA1 and BRCA2 genes and those who inherited Lynch syndrome and Cowden syndrome are at higher risk of endometrial cancer.

Age

Age is also a major factor in endometrial cancer. Women between the age of 50 and 70 have the highest risk.

Reproductive history

Women who have had difficulty getting pregnant, began their period before age 12 or started menopause after age 52 are at increased risk of endometrial cancer.

Hormone use

Women using estrogen-only hormone replacement therapy for menopause or an extended period may be at an increased risk of endometrial cancer.

Other endometrial cancer risk factors

Other risk factors that contribute to endometrial cancer include:

• Smoking: Women who use tobacco products
• Diabetes: Women diagnosed with diabetes
• Endometriosis: Women diagnosed with endometriosis
• 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
• Polycystic ovarian syndrome (PCOS): Women with PCOS, also known as PMOS, who have abnormal hormone levels
• Tamoxifen use: Women who take tamoxifen to treat breast cancer may be at higher risk for endometrial cancer.
• Chemical exposure: Exposure to some hair relaxers may increase risk

The Importance Of Annual Check-Ups

A critical component of women’s health is an annual pelvic exam. However, Dr. Schaut 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. Schaut 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. Schaut. “And as you age, that female pelvic exam should also include a rectal exam.”

 Pelvic exams can check 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.

Can I Be Screened For Endometrial Cancer?

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

What Are Common Signs Of Endometrial Cancer?

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

“The most common and early symptom of endometrial cancer is abnormal bleeding,” Dr. Schaut 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

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 women’s health and cancer teams are 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.

Frequently Asked Questions: Endometrial Cancer

When should I see a gynecologist about abnormal bleeding?

You should schedule an appointment if you experience bleeding between periods, unusually heavy periods, bleeding after menopause, or any new vaginal bleeding that concerns you.

Is bleeding after menopause a sign of endometrial cancer?

Bleeding after menopause is never considered normal and should be evaluated by a healthcare provider. While many conditions can cause postmenopausal bleeding, it can also be an early sign of endometrial cancer.

Is there a screening test for endometrial cancer?

There is currently no routine screening test for endometrial cancer. However, recognizing symptoms and discussing changes with your gynecologist can help lead to earlier cancer diagnosis.

How is endometrial cancer treated?

Endometrial cancer 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.

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.

Can endometrial cancer be cured?

When diagnosed at an early stage, endometrial cancer has a five-year survival rate of nearly 95%.