Intended for healthcare professionals

Clinical Review

Endometrial cancer

BMJ 2011; 343 doi: (Published 06 July 2011) Cite this as: BMJ 2011;343:d3954
  1. Srdjan Saso, clinical research fellow1,
  2. Jayanta Chatterjee, clinical research fellow1,
  3. Ektoras Georgiou, clinical research fellow2,
  4. Anthony M Ditri, general practitioner3,
  5. J Richard Smith, gynaecological surgeon4,
  6. Sadaf Ghaem-Maghami, senior lecturer and honorary consultant in gynaecological oncology5
  1. 1Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Institute of Reproductive and Developmental Biology, Imperial College London, Hammersmith Hospital Campus, London W12 0NN, UK
  2. 2Department of Biosurgery and Surgical Technology, Imperial College London
  3. 3Carshalton, Surrey, UK
  4. 4West London Gynaecological Cancer Centre, Queen Charlotte’s and Chelsea Hospital, Imperial College London, London
  5. 5Imperial College London
  1. Correspondence to: S Saso srdjan.saso{at}
  • Accepted 20 June 2011

Summary points

  • Endometrial cancer is the most common gynaecological cancer in more developed countries and its incidence is increasing in postmenopausal women

  • Postmenopausal bleeding is the hallmark symptom

  • The main risk factors for the development of endometrioid endometrial carcinoma are obesity and chronic unopposed oestrogen stimulation of the endometrium

  • All women with suspected endometrial cancer require transvaginal ultrasonography and most will undergo endometrial biopsy; more sophisticated radiological examinations are required for accurate preoperative staging.

  • Treatment is usually surgical, comprising total hysterectomy and bilateral salpingo-oophorectomy.

  • Adjuvant therapy with radiotherapy, chemotherapy, or hormonal therapy is considered in more advanced or high risk disease

The International Agency for Research on Cancer recently estimated that endometrial carcinoma is the commonest gynaecological cancer in the developed world,1 with a rising incidence in postmenopausal women. In 2007, 7536 new endometrial cancers were diagnosed in the UK, making it the fourth most common cancer in women after breast, lung, and colorectal cancers.2 Cancer of the endometrium is the commonest cancer of the uterine corpus (about 92%, the remainder being uterine carcinosarcomas and sarcomas), according to the Surveillance, Epidemiology and End Results programme of the US National Cancer Institute, which has collected data on cancer from various locations and sources since 1973.3

Cure is possible and the overall five year survival rate for all stages is currently around 80%. Most women present early in the course of the disease when cure is more likely, so primary care practitioners need to be vigilant for potential indicators. We discuss the epidemiology, diagnosis, and treatment of endometrial cancer on the basis of a review of observational research, randomised trials, reviews, and meta-analyses.

Sources and selection criteria

We searched PubMed to identify peer reviewed original research articles, meta-analyses, and reviews. Search terms were endometrial cancer, cancer of the endometrium, endometrial adenocarcinoma, neoplasm and endometrium, and …

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