Uterine cancer

Wednesday 1 April, 2015

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On this page: What is cancer of the uterus? | What are the risk factors? | What types are there? | What are the symptoms? | How common is it?

The uterus, or womb, is part of a woman’s reproductive system. It is about the size and shape of a hollow, upside-down pear. The uterus sits low in the abdomen between the bladder and rectum and is held there by muscle. It is joined to the vagina by the cervix, which is the neck of the uterus. The uterus is where a foetus grows.

The uterus is made up of two layers:

  1. Myometrium: the outer layer of muscle tissue. This makes up most of the uterus.
  2. Endometrium: the inner layer or the lining of the uterus. In a woman of child-bearing age, the endometrium changes in thickness each month to prepare for pregnancy.

When a woman releases an egg (ovum) from her ovary (ovulates), the egg travels down her fallopian tube into the uterus. If the egg is fertilised by a sperm, it will implant itself into the lining of the uterus and grow into a baby. If the egg is not fertilised by a sperm, the lining is shed and flows out of the body through the vagina. This flow is known as a woman’s period (menstruation).

Menopause occurs when the levels of hormones in a woman’s body that cause ovulation and menstruation decrease. A menopausal woman’s periods stop, and she is not able to become pregnant. The uterus becomes smaller and the endometrium becomes thinner and inactive.

A diagram of the female reproductive system

What is cancer of the uterus?

Cancer of the uterus is cancer that begins from abnormal cells in the lining of the uterus (endometrium) or the muscle tissue (myometrium).

What are the risk factors?

The exact cause of cancer of the uterus is unknown, but some factors seem to increase a woman’s risk:

  • being aged over 50
  • being postmenopausal
  • endometrial hyperplasia, a benign condition that occurs when the endometrium grows too thick
  • never having children or being infertile
  • starting periods early (before age 12)
  • reaching menopause late (after age 55)
  • having high blood pressure (hypertension)
  • having diabetes
  • being overweight or obese
  • a family history of ovarian, uterine, breast or bowel cancer 
  • previous ovarian tumours, or polycystic ovary syndrome
  • taking oestrogen hormone replacement without progesterone
  • previous pelvic radiation for cancer
  • taking tamoxifen to treat breast cancer. The risk of uterine cancer is usually outweighed by the benefits of treating breast cancer. Talk to your doctor if you are concerned.

Many women who have risk factors don’t develop cancer of the uterus, and some women who do get cancer have no risk factors.

What types are there?

Uterine cancer can be either endometrial cancer or the less common uterine sarcoma. 

Endometrial cancers

Most cancers of the uterus begin in the lining of the uterus and are called endometrial cancers. There are two main types of endometrial cancer:

Type 1 cancers
Usually called endometrioid cancers. Type 1 cancers are the most common types of endometrial cancer and usually require less intensive treatment.
Type 2 cancers
Include malignant mixed Müllerian tumours, serous carcinoma and clear cell carcinoma. Type 2 cancers are much less common types of endometrial cancer. Treatment usually involves more invasive surgery and chemotherapy and/or radiotherapy.


Uterine sarcomas

These develop in the muscle of the uterus (myometrium) or the connective tissue supporting the endometrium, which is called the stroma. There are three types:

  • endometrial stromal sarcoma
  • leiomyosarcoma
  • undifferentiated sarcoma
These types are rare and may be more likely to spread to other parts of the body.

What are the symptoms?

The most common symptom of cancer of the uterus is unusual vaginal bleeding, particularly if the cancer occurs after menopause. Some women experience a watery discharge, which may have an offensive smell.

Abnormal bleeding or discharge can happen for other reasons, but it is best to check with your general practitioner (GP). They will examine you and refer you for tests to see if you have cancer. Learn more about some types of diagnostic tests.

How common is it?

It is estimated that about 2400 women in Australia are diagnosed with uterine cancer each year.1 The majority of uterine cancers are diagnosed in women aged 50 and over. Uterine cancer is the most commonly diagnosed gynaecological cancer in Australia.

Reviewed by: Dr Sam Saidi, Senior Staff Specialist, Department of Gynaecological Oncology, Chris O’Brien Lifehouse, NSW; Sharon Ellis, Consumer; Anne Finch, Accredited Practising Dietitian, Campaign Project Officer, Cancer Council WA; Harrison Hills, Accredited Practising Dietitian, Nutrition and Physical Activity Project Officer, Cancer Council WA; Suparna Karpe, Clinical Psychologist, Department of Gynaecological Oncology, Westmead Hospital, NSW; Dr Pearly Khaw, Consultant Radiation Oncologist, Peter MacCallum Cancer Centre, VIC; Rosalind Robertson, Senior Psychologist, Gynaecological Cancer Centre, The Royal Hospital for Women, NSW; Deb Roffe, 13 11 20 Consultant, Cancer Council SA, Gynaecological Cancer Research Nurse, QIMR Berghofer Medical Research Institute, SA; Kylie Tilbury, Acting Gynaecology, Brain and CNS Cancer Nurse Care Coordinator, The Canberra Hospital, ACT.
Updated: 01 Apr, 2015