Types of screening tests for endometrial cancer

Screening tests are procedures to check for disease. There are no routine tests used to screen for endometrial cancer, but if your healthcare provider thinks you are at higher-than-average risk, they can check for endometrial cancer in these ways:

• Transvaginal ultrasound. For this test, a wand-like probe is put into your vagina to create images of your uterus. The probe sends out sound waves that echo off the walls of your uterus. A computer translates these sound waves into an image on a screen. The inside of your uterus and changes in the thickness of the lining can be seen. An ultrasound can be used to see if a biopsy is needed.

• Pelvic ultrasound. For this test, a probe is moved over the skin of your lower belly to get images of your uterus. A gel is put on your skin to slide the probe and get good images. Your bladder needs to be full for this test.

• Endometrial sampling. Taking a sample of the cells from the lining of the uterus can be done in several ways. An endometrial biopsy uses a thin, flexible tube that’s put through your vagina and cervix and into your uterus. Cells are then removed through this tube. Hysteroscopy lets your healthcare provider see inside your uterus. It’s done with a small telescope-like tool called a hysteroscope. The tool is inserted through your cervix. This may require the cervix to be opened (dilated). Polyps or other abnormal tissues can be seen and can also be removed. If more cells are needed, a procedure called a dilation and curettage (D&C) is done after you are given medicine to help you relax and sleep. A special tool is inserted through the dilated cervix. The lining of the uterus is removed. The sampled cells are checked under a microscope for cancer.

Who may need screening for endometrial cancer?

Screening tests aren’t advised for women who are at average risk for the cancer. Your healthcare provider may advise screening in these cases:

• You have or may have a gene for hereditary nonpolyposis colon cancer (HNPCC). You may have this gene if HNPCC runs in your family. Or you may have this gene if colon, ovarian, or uterine cancers run in your family. The HNPCC gene puts you at a higher-than-average risk for endometrial cancer. Hereditary nonpolyposis colon cancer (HNPCC) is also known as Lynch syndrome.

• You have known risk factors and are going through menopause.

• You have precancerous changes (hyperplasia) in the cells inside your uterus that may turn into cancer.

Talking with your healthcare provider

If you are at high risk for endometrial cancer, talk with your healthcare provider about an endometrial biopsy. They may advise you to have biopsies after menopause as well. 

If you are at risk for HNPCC, talk to your healthcare provider about extra testing for endometrial cancer at a younger age.

See your healthcare provider if you have any abnormal vaginal bleeding.