Understanding womb cancer

Womb cancer (also referred to as uterine cancer) can affect anyone with a womb, but it’s more common in women who have experienced the menopause. It often affects the lining of the womb – the endometrium – in which case it may be called endometrial cancer. Importantly, womb cancer and cervical cancer are not the same thing.

In the UK, around 9,700 UK women are diagnosed with womb cancer each year. This makes it the fourth most common cancer for UK women.¹ And while survival rates for womb cancer are generally good – almost 80% of patients survive five years or more in the UK² – early intervention is important, as is the case with so many forms of cancer.

So, it’s important to know the risks and be able to recognise the warning signs.

What are the symptoms?

The most common sign of womb cancer is unexpected or unusual vaginal bleeding, especially after menopause.³

Other more common signs include:

• vaginal bleeding between periods
• unusually heavy periods
• abnormal vaginal discharge, which might be pink.

There are other symptoms of womb cancer, which can include:

• a lump or swelling in your tummy or around the pelvis
• pain in your lower back or between your hip bones (pelvis)
• pain during intercourse
• blood in your urine
• abdominal swelling or bloating
• a change in bowel or bladder habits
• a new cough.

Of course, any and all of these symptoms can also be caused by other – more common – conditions, including endometriosis, fibroids and polyps. So, it’s important not to assume anything and to make an appointment to see a doctor as soon as possible.

Who is most at risk?

The risk of developing womb cancer increases with age and, as we’ve mentioned, it’s most common in women who've been through menopause. Recent figures show that more than a quarter (27%) of new cases in the UK are in women aged 75 and over.⁴

>Read more on the menopause in our women’s hub

But it can affect anyone with a womb, and there are a number of other significant risk factors, many of which are linked to having high levels of oestrogen.

These include:

Being overweight

In general, excess body fat can cause the body to produce more oestrogen. This causes the womb's lining to build up and, when more lining cells are produced, there’s a higher chance of one of them becoming cancerous.

Being overweight causes around a third of cases and is one of the biggest preventable risk factors for womb cancer.⁵

Thickened womb lining

Otherwise known as endometrial hyperplasia, a thickened womb lining is usually non-cancerous (benign). But if you have atypical hyperplasia, you could have a higher risk of developing womb cancer.

Symptoms to look out for include heavy periods, bleeding between periods and bleeding after menopause.

Menstrual history

If you started your period at a young age or go through a late menopause, both can cause high levels of oestrogen, which increases the risk of womb cancer.

Other risk factors can include a family history of womb cancer or Lynch syndrome, as well as conditions such as diabetes or polycystic ovary syndrome (PCOS).

Reducing the risk

The good news is, there are also some factors associated with a reduced risk of womb cancer. These include:

• Having had children

Pregnancy and childbirth reduce the risk of womb cancer, and the risk reduces with each child. This is because oestrogen levels are low and progesterone levels are high during pregnancy.

• The pill

The combined pill is linked with a reduced risk of womb cancer and the protective effects can continue for decades after you stop taking it. A non-hormonal intrauterine device (IUD or coil) has also been linked with a decreased risk.

• Physical activity

Being active can help to control hormones such as oestrogen and insulin. Activity can, of course, also help maintain a healthy weight, reducing the risks associated with being overweight, as outlined above.

The NHS lists the following straightforward steps⁶ that you can take to lower the risk of womb cancer.

• maintain a healthy weight
• stay active and take regular exercise
• have a healthy diet and cut down on alcohol
• talk to a GP about the type of contraception you use
• talk to a GP about which HRT is best for you

Diagnosis and treatment

As with many other forms of cancer, womb cancer can often be treated if it’s found early. It’s important to make an appointment to see your GP if you notice any of the symptoms listed above.

Your GP will ask about your family medical history, medical conditions, symptoms and your general health. They may also look to rule out other possible causes by testing for additional symptoms like:

• low red blood cell levels (anaemia),
• high blood sugar,
• or thrombocytosis (high platelet count).

They may also carry out a physical examination, where they check for lumps or changes within the pelvic area. Based on their findings, your GP may then refer you to a specialist.

This doesn’t mean you have cancer, just that further tests will help establish a clear picture. These tests may include:

• a scan of your womb, using a device inserted into your vagina
• a biopsy – removing cells from the lining of your womb
• blood tests

Some of the tests may be uncomfortable, and you might experience cramping or vaginal bleeding after the biopsy.

If you do receive a cancer diagnosis, the news can feel overwhelming and you’ll have a lot of questions. Explore our cancer care articles for more information. If you're a member with AXA Health, here's more information on dedicated cancer support you may have access to.

References

1. What is womb cancer? - Cancer Research UK
2. Uterine cancer survival statistics - Cancer Research UK
3. Symptoms of womb cancer - Cancer Research UK
4. Uterine cancer incidence statistics - Cancer Research UK
5. Risks and causes of womb cancer - Cancer Research UK
6. Womb (uterus) cancer causes - NHS