There are two main types of uterine cancer. Uterine cancers begin in the lining of the uterus (endometrium) and account for about 95% of all cases.  Uterine sarcomas are a rarer form of uterine cancer that develop in the muscle tissue (myometrium).

Uterine cancer is the most diagnosed gynaecological cancer diagnosed in Australian women. Due to an early warning symptom (abnormal uterine/vaginal bleeding) the vast majority of patients with uterine cancers are diagnosed at an early stage.

  • An estimated 3267 women will be diagnosed with uterine cancer in Australia in 2021;
  • Uterine cancer remains as the 5th most commonly diagnosed cancer among females;
  • In the period 2012–2016, individuals diagnosed with endometrial cancer had an 85% chance of surviving for five years compared. Patients with high-risk uterine cancer (ie. uterine papillary serous carcinoma) have a worse outcome.

Screening

There is currently no national screening program for uterine cancer available in Australia.
 

Symptoms

Unusual vaginal bleeding is the most common symptom of uterine cancer, particularly any bleeding after menopause.

Other common symptoms may include:

  • heavier than usual periods or a change in your periods
  • vaginal bleeding between periods
  • periods that continue without a break

Less common symptoms include:

  • a watery discharge, which may have an unpleasant smell
  • unexplained weight loss
  • difficulty urinating or a change in bowel habit
  • abdominal pain

The symptoms of uterine sarcoma include:

  • bleeding between periods
  • bleeding after menopause
  • a mass or lump in the vagina
  • pain or a feeling of fullness in the abdomen (belly)
  • frequent urination

Risk Factors

Some factors can increase your risk of uterine cancer, including:

  • being postmenopausal, or reaching menopause (after age 55)
  • a thickened wall lining (endometrial hyperplasia)
  • never having children
  • starting periods early (before age 12)
  • having high blood pressure or diabetes
  • being overweight or obese
  • family history of ovarian, uterine, or bowel cancer
  • having a genetic condition such as Cowden syndrome or Lynch syndrome
  • previous ovarian tumours, or polycystic ovary syndrome
  • using oestrogen only hormone replacement therapy or fertility treatment
  • previous radiation therapy to the pelvis
  • taking tamoxifen to treat breast cancer (the benefits of treating breast cancer usually outweigh the risk of uterine cancer - (talk to your doctor if you are concerned).

There are no proven measures to prevent uterine cancer. However, you may be able to minimise your risk factors, such as maintaining a healthy weight, and being vigilant about any abnormal vaginal bleeding.

Treatment

Standard treatment is a full hysterectomy, removal of both fallopian tubes and the ovaries. The extent of the disease will be determined by preoperative imaging and removal of lymph nodes along the large blood vessels in the pelvis. Most patients do not require postoperative treatment. However, patients at higher risk of relapse are recommended to have chemotherapy, radiotherapy or a combination of both, depending on the cell type and extent of the disease.

Detailed information about diagnosis testing and  treatment options can be found on the Cancer Australia website.

Research

Current research focuses on less invasive surgical techniques, which may lead to improved recovery from surgery with equal chances for survival. For patients with high-risk uterine cancer, we are trying to find combinations of treatment (including new biological agents) to improve survival.

Sources: Cancer Australia 2021; Cancer Council 2021