Screening tests check for a condition, like cancer, in people who don’t have any signs or symptoms. There aren’t any endometrial cancer screening tests for people at average risk. So, the best way to detect this disease as early as possible is to see your primary care provider if you have any signs or symptoms that concern you.

Some people are at high risk of an endometrial cancer diagnosis due to Lynch syndrome, also called hereditary non-polyposis colon cancer. If you have Lynch syndrome, you may have the option of an endometrial cancer biopsy (where a sample of tissue is taken and sent to a lab to check for cancer), even if you have no symptoms.

Take Charge of Your Health

Talk to your primary care provider if you have symptoms that you think may be endometrial cancer. UW Medicine Primary Care can help you get started. Learn about Fred Hutch's relationship with UW Medicine.

History and Exam for Endometrial Cancer

If you have signs or symptoms that could be from endometrial cancer (or another problem with your reproductive organs), your provider will ask you about your symptoms, your health history and your family history. They may ask about factors that might put you at risk for cancer or other conditions that might cause the same symptoms.

Then, they’ll examine you to check for clues to better understand what’s been bothering you. They will probably do a general physical exam and then a pelvic exam.

Based on your conversation and exam, your provider may order tests to get more information.


Tests for Endometrial Cancer

To diagnose endometrial cancer, physicians have to remove a small sample of tissue from your uterus and look at the cells under a microscope. This is called a biopsy.

Endometrial Biopsy

As part of your endometrial cancer screening, your provider may do an endometrial cancer biopsy. (The endometrium is the inner lining of the uterus.) The provider inserts a thin, flexible, straw-like tube into your uterus through your cervix. They scrape or suction out a small amount of endometrium that is then sent to a lab so a pathologist can examine the cells for cancer.

Dilation and Curettage for Endometrial Cancer

Dilation and curettage (D&C) is another way to get a sample of cells from inside your uterus. The provider inserts a narrow instrument called a dilator into your cervix to open it. Next, they use a curette (spoon-like tool) to scrape some tissue from the uterus for examination. A D&C is less common than an endometrial biopsy. You might need it if you have cervical stenosis — the passageway through your cervix is too narrow to do a biopsy or it’s completely closed.

Imaging Studies for Endometrial Cancer

Your provider may also want you to have imaging studies as part of the diagnosis process. These could give your team more information, such as whether your cancer has spread. Imaging might include an X-ray, ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) scan.

Barbara A. Goff
Dr. Barbara Goff is a Fred Hutch gynecologic oncologist and chair of the Department of Obstetrics & Gynecology at UW Medicine.

Why Choose Fred Hutch for Endometrial Cancer Care

When you choose Fred Hutch Cancer Center for care, our experts confirm your endometrial cancer diagnosis. Before your first visit, your care team will review your pathology slides (tissue samples from biopsies) and any scans or tests you’ve already had. We have a dedicated pathologist who specializes in diagnosing gynecologic cancers. If needed, we will do further tests on your tissue sample.

After your initial consultation with a gynecologic oncologist, we’ll work with you so you can receive some of your treatment in your community, if you prefer.

“Once we evaluate the patient and establish their treatment strategy, we frequently partner with community oncologists to provide care closer to home,” said gynecologic oncologist Barbara Goff, MD. “This is especially helpful for patients who live outside the Seattle area.”

Endometrial Cancer Screening and Diagnosis FAQ

The provider who is doing your procedure will let you know if you need to do anything to prepare. For example, they might recommend taking a nonsteroidal anti-inflammatory drug before an endometrial biopsy to help with discomfort. For a D&C, you might get medicine to make you sleepy (conscious sedation) or you might get regional or general anesthesia so you don’t feel any discomfort during the procedure.

If you do need general anesthesia, you may have to make some changes in the days before or on the day of your biopsy. For example, you may need to stop taking certain medicines or stop eating or drinking the night before. Ask your care team and follow their guidance.

For an endometrial biopsy or D&C, you will lie on your back on an exam table with your feet in stirrups, like for a pelvic exam. Your provider will use a speculum to hold open your vagina, like for a Pap test.

For an endometrial cancer biopsy, your provider will insert a thin tube through your cervix to get a sample of tissue from inside your uterus. It typically takes less than 15 minutes.

For a D&C, your provider will gently stretch open your cervix using thin metal rods. They’ll start with a thinner rod and increase the size step by step. Then they’ll insert the curette through your cervix to get a tissue sample. A D&C usually takes less than 10 minutes. However, your visit will be longer if you have anesthesia, since you need to be given it before the procedure, then monitored after, while you recover.

Both an endometrial biopsy and a D&C may cause cramping, like menstrual cramps, and light bleeding or spotting for a couple of days. Like with many minor procedures, there is a risk of infection, too. Your care team will do everything they can to reduce this risk, and they’ll let you know what to watch for when you are back home. They’ll also let you know some steps to take after the procedure, like not using tampons or having vaginal sex, typically for about a week.

The time it takes for results may depend on which tests the pathologist needs to run. Tests may take from a few days to a week or more. After tests are done, the pathologist will write a report saying what they found and send it to your provider. When you go in for your biopsy or D&C, ask your care team how long it will take to get your results.