Uterine cancer rates are increasing: What can you do to protect yourself?
By Jessica Saenz
Uterine cancer is the most common type of gynecologic cancer. It's estimated that about 65,950 new cases will be diagnosed in 2022, and by 2030 this number will rise to 122,000. Approximately 12,550 people will die from this disease in the U.S. in 2022, according to the National Cancer Institute.
Researchers recently reported that while death rates for the most common type of uterine cancer — endometrioid cancer — remained stable, deaths from rare and aggressive types of uterine cancer increased significantly each year from 2010 to 2017. The study also revealed a disproportionate increase in uterine cancer deaths among the Hispanic, Black and Asian communities.
Although uterine cancer can't be fully prevented, and there is no standard screening for it, an annual pelvic examination is recommended.
Kristina Butler, M.D., a Mayo Clinic gynecologic oncologist, explains what you need to know to stay vigilant and reduce your risk:
Understand uterine cancer types and how they develop.
Like other cancers, uterine cancer can develop when mutations happen in the DNA cells of your uterus and endometrium, also called the endometrial lining. Sometimes, these mutations can turn normal, healthy cells into abnormal cells that grow and multiply uncontrollably and invade nearby tissues.
When this happens, two main types of cancer can develop:
- Endometrial cancer
Endometrial cancer starts in the endometrium. This is the most common type of uterine cancer, and it can often be cured when detected early. Endometrioid cancer is a type of endometrial cancer that starts in gland cells.
- Uterine sarcoma
Uterine sarcoma starts in the muscles and supporting tissues of the uterus. It is much less common but usually more aggressive.
Both types of uterine cancer also have more aggressive subtypes.
Changes in the balance of hormones also can be a risk factor for uterine cancer.
Estrogen and progesterone regulate changes in the endometrium that are part of the monthly menstrual cycle. When estrogen increases but progesterone does not, the risk of endometrial cancer can increase. This can occur with obesity because fat cells increase estrogen without progesterone, which functions to keep the uterus cancer-free.
Certain medications and conditions like polycystic ovarian syndrome and obesity, or changes such as menopause, also can affect your estrogen levels.
"With age, menopause quiets the uterus, but that's when we notice the increased incidence of uterine cancer because abnormal mutations can happen," says Dr. Butler.
Watch for abnormal vaginal bleeding and other symptoms.
Dr. Butler says abnormal vaginal bleeding can be a sign of uterine cancer. If you've gone through menopause and no longer have a monthly menstrual cycle, any amount of blood is considered abnormal. "If you have any bleeding after menopause, it's so important to get checked out quickly," she adds.
For younger people who haven't gone through menopause, abnormal bleeding can include bleeding between your menstrual cycles or after sex, and prolonged or heavy bleeding.
Though in many cases abnormal bleeding can be attributed to noncancerous conditions, it's best to talk to your health care professional if you notice changes in your cycle that are out of the ordinary for you.
Improve your lifestyle choices.
You can reduce some of the known risks of uterine cancer by improving your diet, exercising and maintaining a healthy weight.
"We are seeing a rise in diagnoses of uterine cancer, and we think this is because there's also a rise in other conditions and diseases, such as diabetes, hypertension and obesity," says Dr. Butler.
Obesity increase your risk of uterine cancer because extra weight can affect your menstrual cycle.
"In younger obese people, menses may not occur regularly, which allows thickening, and cancer can develop," she says.
If you need support in reaching your health goals, be sure to talk to your health care professional about support and resources that might be available to you, and learn about how a healthy diet can help reduce cancer risk. Also, taking a birth control pill can lower the risk of uterine cancer by 50%.
Discuss your risk factors with a health care professional you trust.
Awareness of your risk factors for uterine cancer can help you and your health care professional stay ahead of this type of cancer. Although factors like age, family history and certain health conditions might not be in your control, they can help your health care professional decide if testing for uterine cancer is right for you.
If they apply to you, consider discussing these risk factors with your health care professional:
- You have inherited conditions linked to higher cancer risk.
- You have an excessive amount of body fat.
- You started menstruation before the age of 12.
- You went through menopause later in life.
- You have never been pregnant.
- You've had radiation therapy to the pelvis for cancer.
- You've had estrogen-only hormone replacement therapy after menopause.
- You've taken the drug tamoxifen for breast cancer.
Though endometrial cancer isn't usually an inherited disease, familial conditions like Lynch syndrome can increase your risk of developing it. If you don't know your family history, consider talking to a genetic counselor to learn more about your personal risk.
Dr. Butler says it's also important to find a health care professional you trust who makes you feel heard.
"Finding someone you feel comfortable with is key because you have to have open communication," she says. "You should feel safe talking with them and having those intimate discussions."
If you are diagnosed with uterine cancer, Dr. Butler says you should try to seek care from National Cancer Institute-Designated Cancer Centers.
"We know that people have improved outcomes when they go to these centers, because they follow guidelines and provide the best evidence-based care for women," she says.
As cancer experts work to learn more about uterine cancer and better screening, Dr. Butler says the most important thing you can do is stay up to date on your annual screenings, listen to your body and advocate for yourself if something isn't normal.
When it comes to abnormal bleeding, her advice is straightforward: "Don't ignore it. It can be the first sign that something abnormal is happening and can help us detect uterine cancer early."
Watch this "Mayo Clinic Q&A" podcast video to hear Dr. Butler discuss uterine cancer and the increase in endometrial cancer rates and mortality:
Join the Gynecologic Cancers Group on Mayo Clinic Connect.
Also read these articles: