Endometrial Cancer

What is Endometrial Cancer?

Endometrial cancer is a disease where abnormal cells in the lining of the womb (endometrium) grow and divide uncontrollably. These cells can form a lump or tumour and may, in some cases, spread to other parts of the body. The endometrium plays a key role in the menstrual cycle and supporting pregnancy.

Most endometrial cancers are a type called endometrioid adenocarcinoma, which starts in the glandular tissue of the endometrium. Endometrial cancer is most commonly diagnosed after menopause, but it can occur at younger ages too. As with many cancers, early detection greatly improves the chances of successful treatment.

Should I Consider Genetic Endometrial Cancer Testing?

If you have a family history of endometrial cancer, or related cancers such as bowel, ovarian, or stomach cancer, you may want to consider genetic testing. Inherited changes (mutations) in genes such as MLH1, MSH2, MSH6, and PMS2 — associated with Lynch syndrome — can significantly increase the risk of developing endometrial cancer. Genetic testing can help you find out whether you carry one of these mutations, providing important information for your future health and your family’s.

You might be at higher risk if you have two or more close relatives with endometrial or colorectal cancer, if someone in your family was diagnosed at a young age (under 50), or if Lynch syndrome is known in your family. People of Ashkenazi Jewish descent may also carry a higher risk for certain genetic mutations. Around 2–5% of endometrial cancers are thought to be linked to inherited genetic changes. Understanding your genetic risk can open the door to early monitoring, preventative options, and personalised care plans.

What are the Symptoms?

• Unusual vaginal bleeding, particularly after menopause
• Bleeding between periods or unusually heavy periods
• Pelvic pain or discomfort
• Pain during sex
• Unexplained weight loss
• Fatigue

Many of these symptoms can be caused by less serious conditions, but if they are persistent or unusual for you, it’s important to see a doctor. Early diagnosis can make a big difference to treatment outcomes.

What are the causes?

Endometrial cancer can develop due to a combination of factors, including age, hormonal imbalances (especially too much oestrogen), obesity, diabetes, and family history. In many cases, the exact cause isn’t clear.

Inherited genetic mutations play a role in a small but significant proportion of endometrial cancers. Lynch syndrome, caused by changes in mismatch repair genes like MLH1, MSH2, MSH6, and PMS2, greatly increases the risk. Genetic testing can help detect these inherited risks early, allowing for tailored monitoring, risk-reducing strategies, and early intervention if needed.

What other tests are available?

Diagnosis usually begins with a pelvic examination and imaging tests like ultrasound. If there are concerns, a biopsy of the endometrium may be performed to check for cancer cells.

If you are concerned about inherited risk, genetic testing can identify mutations linked to Lynch syndrome and other hereditary conditions. Knowing your genetic status can help you and your healthcare team plan for regular screening and preventative measures to reduce your risk.

How is it treated?

Treatment for endometrial cancer depends on the stage, type, and whether the cancer has spread. Most early-stage endometrial cancers are treated with surgery, often involving removal of the womb (hysterectomy) and possibly the ovaries and fallopian tubes. Depending on the cancer’s features, additional treatments such as radiotherapy, chemotherapy, or hormone therapy may be recommended.

For individuals with inherited genetic mutations, treatment decisions may also consider future risk management, including screening for related cancers. Your care team will work closely with you to develop a personalised plan focused on the best possible outcomes while supporting your overall quality of life.