Endometrial cancer is a common type of cancer diagnosed after menopause. An endometrial cancer diagnosis can feel overwhelming, but learning more about this condition can help you feel more in control and ready to make decisions about your care.

This article will explain the basics of endometrial cancer to help you understand what it is and what to expect.

What Is Endometrial Cancer?

Endometrial cancer is a malignant (capable of spreading) tumor that develops in the endometrium — the inner layer of cells that line the uterine cavity. The uterus is the hollow organ in which a baby grows during pregnancy, also known as the womb. Since endometrial cancer occurs in the uterus, it’s also referred to as uterine cancer.

Types of Endometrial Cancer

The types of endometrial cancer are based on how cancer cells look under a microscope. The most common type is adenocarcinoma, which starts in the gland cells of the endometrium.

Less common types of endometrial cancer include:

• Serous carcinoma — Tends to be aggressive (fast-growing)
• Clear cell carcinoma — Affects cells that look clear under a microscope
• Squamous cell carcinoma — Begins in thin, flat cells
• Small cell carcinoma — Involves tiny, tightly packed cells
• Uterine carcinosarcoma — Has features of both carcinoma (cancer that starts in tissues that line organs) and sarcoma (cancer that starts in muscle cells)
• Mucinous adenocarcinoma — Produces mucus
• Undifferentiated carcinoma — Consists of abnormal cells that grow in a disorganized way

Endometrial cancers can also be grouped into type 1 and type 2 cancers. Type 1 endometrial cancers are more common and are associated with high levels of the hormone estrogen. Type 1 cancers typically grow slowly and usually don’t quickly metastasize (spread) to other parts of the body. Adenocarcinomas are a common type of type 1 endometrial cancer.

Type 2 cancers aren’t linked with high estrogen levels. Type 2 cancers are usually more aggressive and more likely to metastasize. Common type 2 cancers include serous carcinomas and clear cell carcinomas.

Causes of Endometrial Cancer

Cancer occurs when changes in genes allow cells to grow out of control.

Researchers don’t know why some people develop endometrial cancer. Some types are caused by a hormone imbalance that makes the endometrium (lining of the uterus) grow abnormally. In fact, many of the known risk factors for endometrial cancer involve a hormone imbalance.

Endometrial cancer is also linked to certain genetic changes. People with an inherited condition called Lynch syndrome carry genetic mutations (changes) that make it harder for cells to control their growth and repair DNA damage. This results in a higher risk of cancers, including endometrial and colorectal cancer.

Risk Factors for Endometrial Cancer

Certain factors increase the risk of endometrial cancer. This condition is more common with older age, especially after menopause. Other risk factors include:

• Living with type 2 diabetes, metabolic syndrome (a group of co-occurring conditions that raise the risk of heart disease, diabetes, and stroke), or polycystic ovary syndrome (PCOS)
• Starting menstrual periods before age 12
• Beginning menopause at an older age
• Experiencing infertility (inability to become pregnant) or never having been pregnant
• Having a history of endometrial hyperplasia (abnormally thick endometrium)
• Getting diagnosed with breast or ovarian cancer
• Taking tamoxifen, a medication that helps fight some types of breast cancer
• Using estrogen-only menopausal hormone replacement therapy
• Having a family history of colorectal cancer or endometrial cancer
• Eating a high-fat diet
• Being of a higher body weight

It’s important to note that having one or even all the above risk factors doesn’t mean you’ll get endometrial cancer. It’s also a fact that some people develop endometrial cancer without any known risk factors.

Who Gets Endometrial Cancer?

The National Cancer Institute estimated that more than 67,000 new cases of uterine cancer would be diagnosed in the United States in 2024, making up about 3.4 percent of all new cancers. Over the past 10 years, the rate of new endometrial cancers has increased.

Endometrial cancer is the most common type of gynecologic cancer (cancer that affects reproductive organs, including the uterus, ovaries, fallopian tubes, cervix, vagina, and vulva). Endometrial is usually diagnosed after menopause, most often between ages 55 and 64, and it is before age 45. Non-Hispanic Black women are slightly more likely to develop uterine cancer compared with those of other races or ethnicities, according to the National Cancer Institute.

Symptoms of Endometrial Cancer

The most common symptom of endometrial cancer is abnormal vaginal bleeding, which occurs in about 90 percent of cases. Abnormal vaginal bleeding includes:

• A period that’s heavier or longer than usual
• Bleeding between periods
• Any vaginal bleeding after menopause

Abnormal vaginal bleeding usually occurs in early-stage endometrial cancer. Abnormal vaginal discharge, with or without blood, can also be a symptom. In more advanced endometrial cancer, other symptoms may appear, including:

• A lump in your lower abdomen
• Pelvic pain
• Weight loss without trying
• Lower back pain
• Abdominal enlargement

Diagnosis of Endometrial Cancer

Endometrial cancer is diagnosed by a gynecologist (a doctor who diagnoses and treats diseases of the female reproductive system). There aren’t any tests to screen for endometrial cancer before you have symptoms. Most people undergo if they experience symptoms, particularly abnormal vaginal bleeding.

When you go to your gynecologist with possible symptoms of endometrial cancer, they’ll check for other signs of cancer. During a pelvic exam, your health care provider will look at your genitals and feel your uterus and ovaries to check for lumps.

An imaging test called ultrasound gives your gynecologist a real-time view of your uterus, ovaries, and fallopian tubes. A transvaginal ultrasound, which uses a wand placed inside the vagina, offers a clearer image of the uterus to identify masses or abnormal areas in the endometrium.

Although a pelvic exam and ultrasound provide helpful information, the only way to diagnose endometrial cancer is by taking a sample of endometrial tissue and looking at it under a microscope. An endometrial tissue sample is usually obtained using one of these three procedures:

• Endometrial biopsy — A thin tube is inserted into the uterus through the cervix to suction a sample of endometrial tissue.
• Hysteroscopy — A thin telescope inserted into the uterus allows your gynecologist to see inside your uterus and select an area to take a sample.
• Dilation and curettage (D&C) — The cervix is first dilated (widened), and then a spoonlike instrument is inserted into the uterus to scrape a sample of tissue.

The endometrial tissue sample is sent to a laboratory to be examined under a microscope for signs of cancer. If the disease is found, the cancer cells may also be tested for specific proteins and genetic changes that may help direct your treatment options.

Staging of Endometrial Cancer

The stages of endometrial cancer range from stage 1 to stage 4. (Cancer stages are often rendered with Roman numerals, e.g., “stage III” instead of “stage 3.”) In general, the higher the stage, the larger the cancer and the more it has spread.

Your health care provider may order additional tests to check how far your cancer has spread and help with staging. These tests include:

• Imaging tests, such as X-ray and computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans
• Lymph node dissection, a surgical procedure to remove and examine lymph nodes (usually done with removal of the uterus)
• Endoscopy tests, including cystoscopy (to look inside the bladder) and proctoscopy (to examine the rectum)

Treatment for Endometrial Cancer Treated

A team of doctors, usually led by a gynecologist or gynecologic oncologist (cancer specialist), treats endometrial cancer. Your treatment plan depends on your cancer stage and type, overall health, and any plans to have children in the future.

Surgery is the main treatment for most people with endometrial cancer. The most common procedure is a total hysterectomy (removal of the uterus and cervix). Treatment also often includes a bilateral salpingo-oophorectomy (removing the ovaries and fallopian tubes). The tumor’s size, location, and stage determine the extent of surgery.

A side effect of surgery for endometrial cancer is infertility. People with early-stage endometrial cancer who wish to become pregnant may choose to put off surgery until after having children.

After surgery, your cancer care team may recommend additional endometrial cancer treatments, including:

• Radiation therapy
• Chemotherapy
• Hormone therapy
• Immunotherapy
• Targeted therapy

Read more about endometrial treatment options.

Outlook for People With Endometrial Cancer

Overall, about 80 percent of people with endometrial cancer live at least five years after their diagnosis, according to the National Cancer Institute Surveillance, Epidemiology, and End Results Program. This statistic is known as five-year relative survival. Most people are diagnosed with stage 1 endometrial cancer, which can be cured. The five-year relative survival for people with cancer that hasn’t spread is nearly 95 percent. However, for endometrial cancer that has spread to distant parts of the body, the rate drops to about 19 percent.

Talk to your cancer care team to find out more information about your endometrial cancer outlook.

Find Your Team

On MyEndometrialCancerTeam, the social network for people living with endometrial cancer and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with endometrial cancer.

What questions do you have about endometrial cancer? Share your thoughts in the comments below, or start a conversation on your Activities page.