Endometrial cancer - Diagnosing womb cancer

You should visit your GP if you have abnormal vaginal bleeding. While it's unlikely to be caused by womb cancer, it's best to be sure.

Your GP will probably carry out a physical examination of your pelvic area, including your vagina, womb, ovaries, and bladder. They will ask about your symptoms, when they happen, and how often.

You may be referred to a specialist in conditions of the female reproductive organs (a gynaecologist) for further tests. Some of these tests are outlined below.

Transvaginal ultrasound (TVU)

Another test you may have is called a transvaginal ultrasound (TVU). TVU is a type of ultrasound scan that uses a small scanner in the form of a probe.

This is placed directly into the vagina to obtain a detailed picture of the inside of the uterus. The probe can feel a little uncomfortable, but shouldn't be painful.

The TVU checks whether there are any changes to the thickness of the lining of your uterus that could be caused by the presence of cancerous cells.

Biopsy

If the results of the TVU detect changes in the thickness of the lining of the uterus, you will usually have a biopsy to confirm the diagnosis.

In a biopsy, a small sample of cells is taken from the lining of the womb (the endometrium). The sample is then checked at a laboratory for the presence of cancerous cells.

The biopsy can be carried out in several ways, including:

• aspiration biopsy – a small flexible tube is inserted into your vagina and up into your womb, and then sucks up a small sample of cells
• hysteroscopy – this allows the doctor to look at the inside of the womb using a thin type of telescope called a hysteroscope, which is inserted through your vagina and into your womb, allowing the doctor to look at the lining of the womb and take a sample from it

In some cases, a hysteroscopy may be used before dilatation and curettage (D&C). D&C is a minor surgical procedure carried out under general anaesthetic, where some tissue from the womb lining is removed. The tissue is then sent off to a laboratory for further testing.

Blood test

A blood test can sometimes help diagnose womb cancer. This is because some cancerous tumours release certain chemicals into your blood, known as tumour markers, which can be detected during a blood test.

However, this type of test isn't very reliable. The presence of these chemicals doesn't mean you definitely have womb cancer. Some people with womb cancer don't have these chemicals in their blood.

Want to know more?

• Cancer Research UK: womb cancer tests
• Macmillan: how womb cancer is diagnosed

Tests if you have womb cancer

If you're diagnosed with womb cancer, you may have further tests to help determine the stage of the cancer. Staging the cancer will allow the doctors to work out how large the cancer is, whether or not it has spread, and the best treatment options for you.

These tests may include:

• a chest X-ray – where radiation is used to check if the cancer has spread to the lungs
• magnetic resonance imaging (MRI) – where magnetic fields are used to create a detailed image of the inside of your body to check if the cancer has spread
• a computerised tomography (CT) scan – where a series of X-rays are used to create a detailed image of the inside of your body to check if the cancer has spread
• further blood tests – these are usually done to check your general health and how well some of your organs are functioning

See treating womb cancer for more information about staging.

Want to know more?

• Preparing for your cancer test results 
• Cancer Research UK: further tests for womb cancer