Endometrial cancer is a type of uterine cancer that is often detected early because it frequently causes noticeable symptoms. Common warning signs include abnormal vaginal bleeding, especially after menopause, or pelvic pain. If you experience these symptoms, your health care provider may recommend specific tests to check for endometrial cancer.

Keep reading to discover the six key tests health care providers use to diagnose endometrial cancer and how they work.

1. Health History

Your health history includes information about your health now and throughout your life. To better understand your current health and identify risk factors for endometrial cancer, your health care provider will ask questions about your symptoms, past conditions, and family history.

Your doctor may ask questions such as:

• Have you been diagnosed with any other cancers in the past?
• What medications are you taking?
• Have you ever been pregnant?
• What age did you start your menstrual cycle (your first period)?
• At what age did you start menopause?
• Do you have a family history of endometrial cancer or inherited conditions like Lynch syndrome (a genetic condition that raises the risk of several cancers)?

2. Physical Exam

A physical exam helps your health care provider gather information about your overall health and check for signs of endometrial cancer. Information about your overall health may include your height, weight, and vital signs such as heart rate, blood pressure, and temperature.

A pelvic exam is a type of physical exam to check the organs of your reproductive system. During a pelvic exam, your provider will examine your outer genitals and check for any abnormalities in your uterus and ovaries by inserting two gloved fingers into your vagina while pressing on your abdomen (stomach area). In cases of advanced endometrial cancer, lumps or changes in the uterus or surrounding tissue might be detectable.

Your provider may also perform a Pap test during a pelvic exam. A Pap test checks for abnormal cells in the cervix and vagina. Although a Pap test can’t diagnose endometrial cancer, its results can sometimes hint at the need for further testing to rule out the condition.

3. Imaging Tests

Imaging tests give your health care provider a view of the organs inside your body. They can be used to find the location and size of your cancer. Some tests can also show if endometrial cancer has spread to other parts of your body.

Ultrasound

An ultrasound uses sound waves to create images of soft tissues. This test can help locate tumors inside the uterus and measure the thickness of your endometrium (uterine lining). It’s often one of the first tests done when endometrial cancer or another reproductive issue is suspected.

During an ultrasound, a transducer — a device resembling a wand — sends sound waves into your body. These waves bounce off your organs and return to the transducer, where a computer converts them into real-time images.

For endometrial cancer, ultrasounds focus on the uterus, ovaries, and fallopian tubes:

• Pelvic ultrasound — The transducer is passed over the lower part of your stomach.
• Transvaginal ultrasound — The transducer is inserted into the vagina for a clearer image of the uterus.
• Saline infusion sonogram — Saline (salt water) may be added to your uterus before a transvaginal ultrasound to improve the view.

Imaging Tests To Check if Cancer Has Spread

Your health care provider may order additional imaging tests if they suspect your cancer has metastasized (spread). These imaging tests usually aren’t used to diagnose endometrial cancer. However, they can help your cancer care team accurately stage your cancer.

• Chest X-ray — This uses energy beams to create an image of your chest and lungs to check for cancer spread. While helpful, it’s not the most precise test.
• Computed tomography (CT) scan — A CT scan combines multiple X-rays to create detailed cross-sectional images. It’s often used to check if cancer has spread or returned after treatment.
• Magnetic resonance imaging (MRI) — An MRI uses magnetic fields and radio waves to create cross-sectional images of the inside of the body. This test may be used to find out how far cancer has grown into the uterus, to locate enlarged lymph nodes in the pelvis and abdomen, or to detect if cancer has spread to the brain or spinal cord.

• Positron emission tomography (PET) scan — A PET scan uses radioactive tracers to detect areas of the body where cancer may have spread. Health care providers often use them when they suspect advanced endometrial cancer.

4. Endometrial Tissue Sampling

To diagnose endometrial cancer, your health care provider needs to take a sample of the lining of the uterus to examine under a microscope. There are three main procedures to obtain this sample: endometrial biopsy, hysteroscopy, and dilation and curettage.

Endometrial Biopsy

An endometrial biopsy is the most common diagnostic test for endometrial cancer. During the procedure, a health care provider inserts a thin, flexible tube through the cervix into the uterus to collect a small tissue sample using gentle suction.

This procedure is usually done in a health care provider’s office and takes just a few minutes. You may feel some discomfort, similar to menstrual cramps. Over-the-counter pain relievers or a local anesthetic can help reduce any pain.

Hysteroscopy

A hysteroscopy is a procedure in which your health care provider inserts a thin, flexible tube with a light and camera, called a hysteroscope, into your uterus through your cervix. The hysteroscope allows your provider to see inside your uterus and take a sample of any abnormal tissue.

Before this procedure, your provider may fill your uterus with saline to get a clearer view of the endometrium. A hysteroscopy is usually performed while you’re awake, with a numbing medicine to minimize discomfort.

Dilation and Curettage

Dilation and curettage (D&C) is a more invasive procedure to get a tissue sample. You may have a D&C if there wasn’t enough tissue from your endometrial biopsy or if your results aren’t clear.

During the procedure, a provider widens the opening of the cervix (dilation) and uses a spoon-shaped tool called a curette to scrape a sample of the endometrium. A hysteroscopy may also be performed at the same time to guide the process.

A D&C is typically done in an outpatient surgery clinic and takes about one hour. You will likely receive general anesthesia or sedation to keep you comfortable. Most people go home the same day.

5. Endometrial Tissue Testing

After your endometrial tissue sample is collected, it’s sent to a pathologist — a specialist who helps diagnose medical conditions using samples of body tissues. If cancer is found in the tissue sample, the pathology report will give information about the type of cancer and its grade (how abnormal the cells look under a microscope).

The cancer cells can also be tested for specific proteins and genetic mutations (changes in DNA). These tests can check for inherited causes of endometrial cancer. Additionally, some tests can check if new treatments, like immunotherapy, may be effective for you.

Learn more about new treatments and questions to ask your doctor.

6. Blood Tests

There aren’t any blood tests that can directly diagnose endometrial cancer. However, your health care provider may order blood tests to assess your overall health and identify signs that could support a diagnosis or help guide treatment.

Blood tests to check your kidney and liver function may help your cancer care team choose the best treatments for you.

A complete blood count (CBC) measures the type and amount of blood cells you have. If endometrial cancer causes bleeding, your CBC may show that you have anemia (low red blood cell counts).

Another sign of endometrial cancer that might be found through a blood test is cancer antigen 125 (CA-125). CA-125 is a substance that some endometrial cancers release into the blood. A CA-125 blood test isn’t used to diagnose endometrial cancer. However, if you have high levels of CA-125, it could mean your cancer has spread.

Take the Next Step

If you’re experiencing symptoms like abnormal vaginal bleeding or pelvic pain, it’s important to consult your health care provider as soon as possible. Early detection is key, and there are a variety of tests — from ultrasounds and biopsies to advanced imaging and blood tests — that can help identify endometrial cancer and guide treatment options.

Your health care provider will create a personalized diagnostic plan based on your symptoms, medical history, and test results. Be sure to ask questions and share any concerns you have about the procedures or results. Early action can make a significant difference in outcomes, so don’t hesitate to take the next step in your care.

Find Your Team

On MyEndometrialCancerTeam, the social network for people living with endometrial cancer and their loved ones, members come together to gain new insights into endometrial cancer and share their stories with others who relate to life with the condition.

What tests did you have to diagnose endometrial cancer? Share your experience in the comments below or post to your Activities page.