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Cancer of the uterus overview

Page last updated: November 2025

The information on this webpage was adapted from Understanding Cancer of the Uterus - A guide for people affected by cancer (2025 edition). This webpage was last updated in November 2025.

Expert content reviewers:

This bookley is based on Australian and international clinical practice guidelines. All updated content has been clinically reviewed by Professor Alison Brand, Clinical Professor, The University of Sydney and Director, Department of Gynaecological Oncology, Westmead Hospital, NSW.

This edition is based on the previous edition, which was reviewed by the following panel of health professionals and people affected by cancer of the uterus:

A/Prof Orla McNally, Consultant Gynaecological Oncologist, Director Oncology/Dysplasia, Royal Women’s Hospital, Honorary Clinical Associate Professor, University of Melbourne, and Director of Gynaecology Tumour Stream, Victorian Comprehensive Cancer Centre, VIC
A/Prof Yoland Antill, Medical Oncologist, Peninsula Health, Parkville Familial Cancer Centre, Cabrini Health and Monash University, VIC
Grace Guerzoni, Consumer
Zeina Hayes, 13 11 20 Consultant, Cancer Council Victoria
Bronwyn Jennings, Gynaecology Oncology Clinical Nurse Consultant, Mater Hospital Brisbane, QLD
A/Prof Christopher Milross, Director of Mission and Radiation Oncologist, Chris O’Brien Lifehouse, NSW
Mariad O’Gorman, Clinical Psychologist, Liverpool Cancer Therapy Centre and Bankstown Cancer Centre, NSW.

What is cancer of the uterus?

Cancer of the uterus (also called uterine cancer, endometrial cancer, womb cancer, or cancer of the lining of the womb) occurs when cells in any part of the uterus become abnormal, grow out of control and form a lump (tumour).

It can be either endometrial cancer (which accounts for about 95% of cancers of the uterus) or the less common uterine sarcoma (which accounts for about 5%).

Endometrial cancer

This cancer begins in the cells in the lining of the uterus (called the endometrium). Endometrial cancer is divided into four main subtypes. Knowing these subtypes helps the doctor to work out what, if any, treatment is needed after surgery.

Tests on tissue samples collected before or during surgery help the doctor to work out the subtype. The four subtypes are:

POLE mutant – usually treated with surgery only; often has a good outcome
mismatch repair deficient (MMRd) – additional treatment like immunotherapy may be needed after surgery; may be inherited (Lynch syndrome)
p53 abnormal – usually needs treatment after surgery
no specific molecular profile (NSMP) – may need treatment after surgery.

Uterine sarcoma

These rare soft tissue cancers develop in the cells in the muscle of the uterus (myometrium) or connective tissue (stroma). There are three types of uterine sarcoma:

endometrial stromal
leiomyosarcoma, and
undifferentiated.

The uterus

The uterus, or womb, is where a baby grows during pregnancy. It is part of the female reproductive system, which also includes the ovaries, fallopian tubes, cervix (neck of the uterus), vagina (birth canal) and vulva (external genitals).

Diagram of the female reproductive system

Shape and position in the body – The uterus is about the size and shape of a hollow, upside-down pear. It sits low in the abdomen (belly) between the bladder and rectum, and is joined to the vagina by the cervix. The ovaries sit on either side of the uterus. The ovaries contain eggs (ova) and are connected to the uterus by the fallopian tubes.
Layers – The uterus has two layers. The myometrium is the outer layer of muscle tissue and makes up most of the uterus. The endometrium is the inner layer or lining.
Menstruation – Each month, from puberty to menopause, the endometrium becomes thicker to prepare for pregnancy. If a pregnancy does not occur, some of the lining is shed and flows out of the body through the vagina. The flow is called a monthly period or menstruation.
Menopause – The hormones oestrogen and progesterone control the release of eggs (ovulation) and the timing of menstruation. As you get older, the ovaries gradually produce less of these hormones. When the levels of oestrogen and progesterone fall low enough, periods become irregular and finally stop. This is known as menopause. After menopause, it is not possible to conceive a child naturally. The uterus also becomes smaller and the endometrium becomes thinner.

Your guide to best cancer care

A lot can happen in a hurry when you’re diagnosed with cancer. The guide to best cancer care for endometrial cancer can help you make sense of what should happen.

It will help you with what questions to ask your health professionals to make sure you receive the best care at every step.

Read the guide

Symptoms?

The most common symptom of cancer of the uterus is unusual vaginal bleeding. This may include:

bleeding or spotting after menopause
heavier than usual periods or other changes in periods
bleeding between periods
constant bleeding (periods that continue without a break).

A less common symptom is a smelly, watery vaginal discharge. In rare cases, symptoms include abdominal (belly) pain, unexplained weight loss, difficulty urinating (weeing) or a change in bowel habit (pooing).

Any of these symptoms can happen for other reasons, but it is best to see your doctor for a check-up.

How common is it?

Each year, about 3400 Australian women are diagnosed with cancer of the uterus, and most are over 50 years of age.

Cancer of the uterus is the fifth most common cancer in women and the most commonly diagnosed gynaecological cancer (cancer affecting the female reproductive system).

The number of women diagnosed with cancer of the uterus has increased in recent years, including in younger women. This is likely to be linked to rising rates of obesity and diabetes, as well as more people living to older ages.

Anyone with a uterus can get cancer of the uterus – women, transgender men, non-binary people and people with intersex variations. For information specific to you, speak to your doctor.

LGBTQI+ People and Cancer

Risk factors?

The exact cause of cancer of the uterus is unknown, but factors that can increase the risk include:

age – cancer of the uterus is most common in women aged over 50 and in women who have stopped having periods (postmenopausal)
body weight – carrying extra body weight (overweight or obese) is a major risk factor
medical factors – having diabetes; having previous radiation therapy for cancer in the pelvic area; having endometrial hyperplasia
family history – having an inherited change in a gene (mutation) linked with endometrial cancer (e.g. Lynch syndrome or Cowden syndrome), or having one or more close blood relatives diagnosed with cancer of the uterus or ovarian cancer
reproductive history – not having children
hormonal factors – starting periods before the age of 12; going through menopause after the age of 55; taking some types of oestrogen-only menopausal hormone therapy (MHT, previously called hormone replacement therapy or HRT); or taking tamoxifen, an anti-oestrogen drug used for breast cancer.

Many people who have risk factors don’t develop cancer of the uterus, and some people who get this cancer have no risk factors. If you are concerned about any risk factors, talk to your doctor.

Maintaining a healthy body weight and being physically active are the best ways to reduce the risk of developing cancer of the uterus.

Other conditions of the uterus

Some conditions can affect the uterus and cause abnormal vaginal bleeding and pain. They may be found during tests for cancer of the uterus.

Polyps – Small, soft growths attached to the inner wall of the uterus. Polyps are usually benign (not cancer), but some may turn into cancer. They can be removed during a hysteroscopy and tested for cancer.
Fibroids – Benign tumours that begin in the muscle layer of the uterus (myometrium). Surgery may be used to reduce the size of the fibroid (myomectomy) or remove the uterus (hysterectomy).
Endometrial hyperplasia – Thickening of the uterus lining (endometrium) caused by too much oestrogen. Usually benign, but can lead to cancer, so may be treated with hormones, minor surgery or, in some cases, hysterectomy.
Endometriosis – When endometrial tissue grows outside the uterus (e.g. in the abdomen). Does not usually lead to cancer. May be treated with surgery or hormones.

Which health professionals will I see?

Your general practitioner (GP) will arrange the first tests to assess any symptoms. If these tests do not rule out cancer, you will be referred to a gynaecological oncologist or gynaecologist for more tests.

If cancer of the uterus is diagnosed, the specialist will consider treatment options. To ensure the best outcome, it is recommended that you are treated by a specialist gynaecological cancer team.

Treatment options will often be discussed with other health professionals at what is known as a multidisciplinary team (MDT) meeting.

During and after treatment, you may see a range of health professionals for various aspects of your care, such as a gynaecological oncologist, cancer genetics specialist and women’s health physiotherapist.