Endometrial Cancer Awareness: Answer Guide

Below, you can find the answers to the “Endometrial Cancer Awareness” section of the DETECTR questionnaires. If you have further questions about endometrial cancer symptoms or risk, please speak to your healthcare provider.

Question 1. Some of the following could be symptoms of uterine cancer. Tell us which you think are common symptoms of uterine cancer:

	Common	Less Common
Bleeding in between your periods?*	X
Having heavier periods than normal?*	X
Vaginal bleeding after menopause?*	X
Bloody or pink and watery vaginal discharge?*	X
Pain or discomfort in the pelvic area?		X
Pain during sex?		X
Having a low blood or iron count (i.e. anaemia)?	X
Weight loss?		X

*These are examples of abnormal uterine bleeding, which is a major symptom of endometrial cancer and should always be investigated.

Question 2. These are some things that can increase a woman’s chance of developing uterine cancer. How much do you agree that each of these things can increase the risk of developing uterine cancer?

	Decreases Risk	Increases Risk	No Impact on Risk
Not having children via a live birth		X
Starting periods at a young age		X
Having gone through menopause		X
Having a late menopause		X
Having a close relative with uterine or bowel cancer		X
Having had a hysterectomy (uterus removed)	X
Having a negative Pap smear or HPV test*			X
Having polycystic ovary syndrome (PCOS)		X
Having diabetes		X
Being overweight (BMI over 30)		X
Living a sedentary lifestyle (i.e., not being physically active)		X
Being a smoker**	X
Taking the combined (estrogen, progesterone) hormonal pill***	X
Using tamoxifen (medication) for breast cancer treatment or prevention		X

*The Pap smear is a method of screening for cervical cancer, not endometrial cancer. Similarly, the HPV test is a method of assessing if someone is at high risk for cervical cancer. Testing positive for herpes simplex virus (HSV), the number of sexual partners, and having unprotected sex does not affect endometrial cancer risk.
**Smoking cigarettes should not be used as a method of decreasing endometrial cancer risk, as it may increase your risk of lung cancer or other health problems. Please speak to your healthcare provider if you have further questions about smoking and/ or smoking cessation.
*** While the combined (estrogen and progesterone) hormonal pill decreases risk of endometrial cancer, taking hormonal pills containing estrogen without progesterone increases risk of endometrial cancer.

Question 3. Uterine cancer diagnosis and management. Can you tell us which of the following statements are TRUE or FALSE?

	True	False
In Canada, uterine cancer is more common than cervical or ovarian cancer*	X
Uterine cancer is usually diagnosed at an early stage (before it has spread)	X
Uterine cancer is easily treated	X
Uterine cancer has a poor prognosis (outlook)	Uterine cancer survival rates depend on the tumour type and stage at diagnosis. Please find more information here.
Uterine cancer can run in families	X

*The lifetime risk of developing uterine cancer is 3.3% in Canadian women+, which is comparable to other well-known cancers like colorectal cancer (5.5%) and lung cancer (7.1%). In contrast, the risk of developing cervical or ovarian cancer is much lower at 0.7% and 1.3%, respectively. In fact, uterine cancer is the most common gynaecological cancer in Canada, with incidence increasing in recent years due to an increase in risk factors such as obesity.

Sources:

Jones O, Young H, Clarke H, Crosbie EJ, Sivalingam VN. The Womb Cancer Awareness Measure (WCAM): Development of an instrument to assess public awareness of endometrial cancer. Int J Gynecol Cancer. 2024;34(1):73-79. doi:10.1136/ijgc-2023-004796
Fraser IS, Critchley HOD, Broder M, Munro MG. The FIGO recommendations on terminologies and definitions for normal and abnormal uterine bleeding. Semin Reprod Med. 2011;29(5):383-390. doi:10.1055/s-0031-1287662
Munro MG, Critchley HOD, Fraser IS, FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393-408. doi:10.1002/ijgo.12666
Raglan O, Kalliala I, Markozannes G, et al. Risk factors for endometrial cancer: An umbrella review of the literature. Int J Cancer. 2019;145(7):1719-1730. doi:10.1002/ijc.31961
Canadian Cancer Statistics Advisory Committee in collaboration with the Canadian Cancer Society, Statistics Canada and the Public Health Agency of Canada. Canadian Cancer Statistics 2023. Toronto, ON: Canadian Cancer Society; 2023.