There are no screening tests for endometrial cancer that are recommended for women who are at average risk for the cancer. Fortunately, most women with endometrial cancer will see their health care provider about abnormal vaginal bleeding and be diagnosed with early-stage disease which is very treatable. Yearly pelvic exams and any other exams and tests suggested by your doctor are good ways to check your overall reproductive health. However, they are not very helpful at finding endometrial cancer early.
Your doctor may suggest screening for endometrial cancer in these cases:
You are a known carrier of, or likely to carry, a gene mutation for the disease hereditary nonpolyposis colon cancer (HNPCC). You may carry this gene if HNPCC runs in your family or your family has a tendency to get colon, uterine, ovarian, or certain uterine cancers.
You have known risk factors and are going through menopause.
You have precancerous changes (hyperplasia) in the cells inside your uterus that might turn into cancer.
Women at increased risk should be informed of their risk and advised to see their doctor whenever there is any abnormal vaginal bleeding or discharge.
If you are at high risk for endometrial cancer, your doctor may talk to you about an endometrial biopsy. He or she may advise you to have a biopsy periodically after menopause as well. If you are at higher risk for HNPCC, you should be offered testing for endometrial cancer each year with an endometrial biopsy starting at age 35, according to the American Cancer Society.
If your doctor thinks you are at risk, he or she can check for endometrial cancer in these two ways:
Endometrial sampling. Taking a sample of the cells from the lining of the uterus can be done in several ways. With an endometrial biopsy, your doctor inserts a thin flexible tube through your vagina and cervix and into your uterus and removes some cells through this tube. Another procedure, called a hysteroscopy, allows your doctor to see inside your uterus with a small telescope inserted through your cervix. In addition to sampling tissue from the lining of the uterus, polyps or other abnormal tissues can be removed. Sometimes, more cells are needed for examination, and an outpatient surgical procedure called a dilation and curettage (D&C) is done. A special instrument is inserted through the dilated (opened) cervix and the lining of the uterus is removed. The sampled cells are examined under a microscope to check for cancer. These tests may cause you some mild discomfort, which feels like menstrual cramps, and bleeding. There is also a risk for possible infection. In rare cases, the wall of your uterus could be punctured.
Transvaginal ultrasound. Your doctor puts a probe into your vagina to make images of your uterus. The probe sends out sound waves that echo off the walls of your uterus. A computer translates these sound waves into an image on a nearby screen. In this way, your doctor can see an image of the inside of your uterus. The diagnosis of endometrial cancer is made with a biopsy, but an ultrasound may reveal certain findings that prompt the doctor to do a biopsy.