Endometrial Cancer

Endometrial cancer is the most common cancer of the female reproductive organs. It starts in the endometrium, a layer of tissue that lines the interior of the uterus, or womb.

The uterus is where a fetus grows when a woman is pregnant. It is hollow and pear shaped with two main parts:

• The cervix, which is the bottom part and extends into the vagina (the birth canal)
• The body of the uterus, which is the upper part. This also may be called the corpus. It has two main parts: the muscle wall, which contracts when a woman has a baby, and the endometrium.

Prior to menstruation (also called a period), a woman’s endometrium becomes thicker. If she does not become pregnant, the new endometrial tissue is shed as menstrual flow (blood). This happens about every month until a woman stops having periods. When a woman stops having periods it is called menopause.

Endometrial and uterine cancer types

Almost all uterine cancers start in the endometrium, which is the lining of the uterus. The most common endometrial cancer is endometrial adenocarcinoma. Adenocarcinomas are cancers that form from cells that line the inside of certain organs.

Uterine sarcoma is a rare cancer of the uterus, but it is not an endometrial cancer. It is a soft tissue sarcoma that forms in the muscle wall of the uterus. Learn more about soft tissue sarcomas.

Uterine carcinosarcoma are a third type of uterine cancer. These cancer cells look like a mix of endometrial adenocarcinoma cells and sarcoma cells.

Uterine serous carcinoma is a malignant form of serous tumor that can form in the uterus. It is an uncommon form of endometrial cancer that usually affects postmenopausal women.

Clear cell carcinoma (CCC) comprises a rare yet an aggressive subtype, accounting for less than 5% of all uterine carcinomas.

Endometrial cancer statistics

Each year, about 66,000 women in the United States are diagnosed with uterine cancer. Almost all of these are endometrial cancers.

Nearly 80% of cases are diagnosed in women age 55 or older. However, the number of younger women with endometrial cancer is going up.

Most endometrial cancers develop over a period of years. They may start as less serious problems such as endometrial hyperplasia, which is an overgrowth of cells in the lining of the uterus.

Fortunately, many endometrial cancers are found early because of warning signs such as abnormal or postmenopausal bleeding. If endometrial cancer is found in the earliest stages, it often can be treated successfully.

Endometrial cancer risk factors

Anything that increases your chance of getting endometrial cancer is a risk factor. These include:

• Obesity: Being overweight raises your risk two to four times. A higher level of fat tissue increases your level of estrogen which can stimulate the endometrial lining to grow.
• Eating a diet high in fat.
• Age: More than 95% of endometrial cancers occur in women 40 and older.
• Tamoxifen: This breast cancer drug can cause the endometrial lining to grow. If you take tamoxifen and have changes in your menstrual period or bleeding after menopause, it is important to let your doctor know.
• Estrogen replacement therapy (ERT) without progesterone if you have a uterus. Birth control pills may lower your risk.
• Personal/family history of endometrial, ovarian or colon cancer. This may be a sign of Lynch syndrome (hereditary non-polyposis colorectal cancer or HNPCC). Learn more about hereditary cancer syndromes.
• Ovarian diseases, such as polycystic ovarian syndrome (PCOS).
• Complex atypical endometrial hyperplasia: This precancerous condition may become endometrial cancer if not treated. Simple hyperplasia rarely becomes cancer.
• Diabetes.
• Never having been pregnant.
• Number of menstrual cycles (periods): If you started having periods before 12 years old or went through menopause late, your risk of endometrial cancer may be higher.
• Breast or ovarian cancer.
• Pelvic radiation to treat other kinds of cancer. The main risk factor for uterine sarcoma is a history of radiation therapy in the pelvic area.

Not everyone with risk factors gets endometrial cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor.

Learn more about endometrial cancer:

• Endometrial cancer symptoms
• Endometrial cancer diagnosis
• Endometrial cancer treatment

Behavioral and lifestyle changes can help prevent endometrial cancer. Visit our prevention and screening section to learn how to manage your risk.

Some cases of endometrial cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.

Why choose MD Anderson  for endometrial cancer treatment?

MD Anderson's Gynecologic Oncology Center focuses an incredible level of expertise and experience on each patient with endometrial cancer. From diagnosis through treatment and follow-up, your care is personalized and designed especially for you.

Teams of some of the nation's top endometrial cancer experts consider all the options, and then they recommend the most advanced therapies while working to minimize side effects. They have at their fingertips the latest technology and techniques, backed by one of the leading endometrial cancer research programs in the United States.

Personalized endometrial cancer treatment

Your treatment team, which may include gynecologic oncologists, radiation oncologists; pathologists; and diagnostic radiologists, collaborates and communicates each step of the way. A specially trained staff with experience in caring for women with endometrial cancer supports the team.

Surgery is the primary treatment for most endometrial cancers. At MD Anderson, our highly specialized surgeons are among the most experienced and skillful in the country. In many cases, they are able to perform minimally invasive surgeries and use robotic surgery for endometrial cancer. These procedures may help lessen the time it takes you to heal and the time you need to spend in the hospital.

Specialized care and research

At MD Anderson, we go beyond treating disease. We are dedicated to helping women who have been treated for endometrial cancer get back to a healthy life. For instance, we offer special support groups just for women with cancer of the uterus.

Our Gynecologic Genetics Clinic provides genetic counseling for women at risk of inherited cancer syndromes.

In addition, we are working toward a better understanding of endometrial cancer on a molecular basis. We're leading the way in endometrial cancer research, which means we offer a variety of clinical trials of new therapies.