What Is a Significant Early Sign of an Endometrial Carcinoma?

The cause of endometrial carcinoma is not clearly known. Endometrial cancer results when changes (mutations) in the DNA of the endometrial cells cause uncontrolled multiplication and growth of the cells. Normally, the cells die and new cells are formed. In the case of cancer, cell division is uncontrolled.

Six risk factors that increase a woman’s risk of endometrial carcinoma include

• Changing levels of hormones: Having a condition that causes only the estrogen (and not progesterone) levels to be high increases the risk of endometrial carcinoma. These conditions include
  • Polycystic ovarian syndrome (PCOS)
  • Obesity
  • Diabetes
  • Estrogen therapy for breast cancer
  • Tamoxifen therapy
• Older age: Women who are 60 years of age or older are more at risk of endometrial cancer than younger women.
• Not getting pregnant: The risk of endometrial carcinoma is more in women who have never been pregnant than in those who have had at least one pregnancy.
• Being overweight: Excess fat disturbs normal hormone levels.
• More years of menstrual periods: Getting the first period earlier than 12 years of age or getting menopause at a very late age increases the risk of endometrial cancer.
• Genetic tendency: Certain genetic syndromes that run in families increase the risk of endometrial cancer. A disease called Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC) increases the risk of colon cancer and other types of cancer, including endometrial cancer. Lynch syndrome is caused by a gene mutation passed from parents to children.

Currently, no screening test can detect endometrial cancer in a woman with no symptoms. If a young woman has symptoms of abnormal bleeding and other signs and symptoms of endometrial cancer, the doctor will take their complete medical history. The doctor will perform the following tests to check if they have endometrial carcinoma.

• Transvaginal ultrasound exam: The doctor will insert a special probe that uses sound waves to create pictures of the uterus into a woman’s vagina. This test called a transvaginal ultrasound lets the doctor know the size of the uterus and thickness of the endometrium.
• Hysteroscopy: In this, the doctor inserts a hysteroscope (a thin, flexible, tube-like lighted camera) into a woman’s vagina to visualize the uterus and its endometrium.
• Endometrial biopsy: It involves the removal of a piece of the endometrium and sending it to the laboratory to examine it under a microscope. This can be done in a doctor’s office or sometimes through a surgery known as dilatation and curettage (D&C).