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Screening for Uterine (Endometrial) Cancer
Screening is a way to evaluate people without symptoms to determine if they are at risk for cancer or have already developed cancer.
There are no routine universal screening tests for uterine cancer.
Patients with high risk for endometrial cancer or atypical hyperplasia may be screened. Screening is recommended only for women with certain risk factors, such as hereditary nonpolyposis colorectal cancer, a rare familial syndrome in which multiple family members often develop bowel tumors and other tumors. These women should be followed closely by a doctor or team of doctors with expertise in cancer genetics. For a period of years, screening was recommended for all patients taking tamoxifen, but the current recommendation is not to screen, but to test if uterine bleeding occurs.
If you have symptoms such as vaginal bleeding after you go through menopause, or heavy or irregular bleeding before menopause, you should discuss these with your doctor.
Endometrial biopsy —This procedure is not considered a routine screening test. More often it is performed if you are having symptoms that raise concern as to your risk for uterine cancer. During a pelvic exam, the doctor will remove a tissue sample from the lining of the uterus. You will lie on a table with your feet in stirrups. A speculum is used to open the vagina and an instrument called a tenaculum is used to grasp the cervix. The doctor then passes a thin, flexible instrument through the vagina and into the uterus. This tool is used to remove a small sample of endometrial tissue. You may experience some cramping, pain, tugging, and/or pressure during this procedure.
In the laboratory, the pathologist will examine the sample for cancer cells, a procedure that usually takes about 10-15 minutes.
Transvaginal ultrasonography —Also not routinely used as a screening test, this ultrasonography is a way of taking a picture of the uterus using echoes from sound waves. The endometrial layer inside the uterus can be seen and measured. Excessive thickness may be an indication for further testing. This test is often used if you are experiencing problems like abnormal vaginal bleeding.
American Cancer Society website. Available at: http://www.cancer.org/ .
Bast R, Kufe D, Pollock R, et al, eds. Cancer Medicine. 5th ed. Hamilton, Ontario: BC Decker Inc; 2000.
National Cancer Institute website. Available at: http://www.nci.nih.gov/ .
Rakel R. Bope E, ed. Conn's Current Therapy. 54th ed. St. Louis, MO: WB Saunders; 2002: 1094-1096.
Last reviewed September 2011 by Igor Puzanov, MD
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