Womb cancer's earliest symptoms and how the disease is treated

Cancer of the womb is the fourth most common cancer for women in the UK, with around 9,800 new cases every year, according to Cancer Research.

In Scotland, there were 802 women diagnosed with Endometrial Cancer (a type of womb cancer) over the period October 2022 to September 2023.

But an exciting advancement has been made in terms of diagnosing the disease, as a new, less invasive test to diagnose womb cancer, called WID-easy, has been approved for use in the UK.

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Using PCR technology similar to that of Covid tests, the new process involves a simple swab sent to a lab for DNA analysis. The test identifies DNA changes that may indicate womb cancer, providing an alternative to traditional methods like transvaginal ultrasounds or hysteroscopies.

If the test suggests the presence of cancer, further confirmation through a biopsy is required. The new test, by University College London (UCL) spinout company Sola Diagnostic, has been approved by the Medicines and Healthcare products Regulatory Agency (MHRA).

It is now available for women over 45 with abnormal uterine bleeding in private clinics, with hopes for future availability on the NHS.

But what exactly causes womb cancer, and what early signs should we be aware of? Here's everything you need to know about the disease.

What is womb cancer?

“Womb cancer is a type of cancer that starts in the uterus (womb),” says Ms Sangeeta Khinder, consultant obstetrician and gynaecologist at London Gynaecology.

“The most common type [of womb cancer] is endometrial cancer, which begins in the lining of the womb.”

A less common, but more aggressive, type of womb cancer is called uterine sarcoma. “This type develops in the muscle of the womb,” she notes.

Womb cancer is the fourth most common cancer among women and individuals with gynae organs, according to The Eve Appeal.

What causes womb cancer?

“Endometrial cancer develops when the cells in the lining of the uterus (endometrium) grow uncontrollably, often due to hormonal imbalances,” explains Khinder.

“High levels of oestrogen, especially when unopposed by progesterone, can cause excessive thickening of the endometrium, increasing the risk of cancerous changes.

“Several factors contribute to this imbalance, including obesity, polycystic ovary syndrome (PCOS), and oestrogen-only hormone replacement therapy (HRT).”

The gynaecologist adds that conditions such as diabetes and a family history of uterine or colorectal cancer can also increase this risk.

What are some early symptoms to look out for?

The main symptom of womb cancer is abnormal vaginal bleeding, according to The Eve Appeal. This includes any unexpected bleeding, particularly after menopause or between periods.

“If there is any bleeding between periods or if the periods are prolonged or heavier, this needs to be taken seriously and investigated,” says Khinder.

Abnormal vaginal discharge, especially in the menopause, should also be flagged up to a doctor, adds Khinder.

Who is more at risk?

Most women diagnosed with womb cancer have been through their menopause and are aged 75 to 79, according to Cancer Research.

“The lifetime risk of a getting endometrial cancer is one in 100 and peak incidence is after menopause in 50s and 60s, hence it’s important for women in the menopause to be aware of the signs and symptoms,” says Khinder.

“Other risk factors such as high BMI, diabetes and PCOS also increases the risk of this type of cancer.”

What are the treatment options?

The most common treatment for womb cancer is a hysterectomy, which is the surgical removal of the uterus.

“A simple hysterectomy, which is often carried out as a key-hole procedure, is often the only treatment needed for early low grade endometrial cancers,” explains Khinder.

“A key-hole hysterectomy is associated with tiny incisions, a short hospital stay and quick recovery.”

Following a hysterectomy, the cancerous cells are tested further to determine if they have spread beyond the inner half of the uterine wall.

“If this is a possibility, further treatment with radiotherapy may be offered to minimise chances of cancer cells coming back,” says Khinder.