What tests help diagnose endometrial (uterine) cancer?

Since endometrial cancer begins inside the uterus, it does not usually show up in the results of a Pap test. For this reason, a sample of endometrial tissue must be removed and examined under a microscope to look for cancer cells.

One of the following procedures may be used:

Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells. Dilatation and curettage: Surgery to remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken and checked under a microscope for signs of disease. This procedure is also called a D&C.

This answer is baed on source information from the National Cancer Institute.

Diagnostic equipment and surgical procedures may help detect and diagnose endometrial cancer:
  • Hysteroscopy: A tiny viewing scope is inserted through your vagina and cervix to view the inside of the uterus.
  • Dilation and curettage (D&C): a more extensive type of biopsy, D&C involves inserting an instrument through your vagina into the uterus where it scrapes away the inside lining of the uterus.
  • Ultrasound: uses sound waves to view internal body structures and to examine blood flow in different areas of the body. It can be used to examine the reproductive organs including the uterus and measure the thickness of the uterine lining.
  • Cystoscopy or proctoscopy: To check to see if cancer has spread to your urethra or bladder, a thin, lighted tube (cystoscope) is inserted through the urethra. Similarly, a proctoscope is inserted into the rectum to check for cancer there.
  • Computed tomography (CT) scan: combines multiple x-rays to provide three-dimensional clarity and show various types of tissue, including blood vessels. CT not only confirms the presence of a tumor but can show its precise location, size, and involvement with adjacent tissue.
  • Magnetic resonance imaging (MRI): magnets and radio waves provide three-dimensional images of the body. MRI is used to view biochemical changes in the body to detect cancerous tumors, particularly those that have spread outside the uterus. It may also be used to determine if a tumor is benign or malignant.
  • Positron emission tomography (PET): A specific dye injected into your vein highlights cancer cells growing anywhere in the body, which can then be detected by a special camera.
  • CA-125 test: This blood test looks for elevated levels of a substance that could indicate the presence of cancer.
  • Other tests: Chest x-rays, a special x-ray of the urinary system (intravenous pyelogram) and various blood tests are some of the other diagnostics that may be prescribed.
The first step in diagnosing uterine cancer is a pelvic exam. During this routine exam, your doctor will simply feel the shape of your uterus in your lower abdomen. To confirm uterine cancer, you may undergo a biopsy, an ultrasound, or further tests to be sure that the cancer has not spread. If information from these tests is not sufficient, your doctor may also perform a dilation and curettage test, which allows him or her to closely examine cells from the uterine lining.
Sharyn N. Lewin, MD
OBGYN (Obstetrics & Gynecology)
Routine screening for uterine cancer is not usually recommended. If you or your doctor suspect that you might have uterine cancer your doctor will likely perform:
  • Pelvic Exam
  • Transvaginal ultrasound
  • Biopsy of the endometrium (lining of the uterus)
There are a few different tests doctors rely on to help diagnose endometrial (uterine) cancer, which are separate from a pap smear. In this video, I will describe the various screening methods available to women.
Kristine A. Borrison, MD
OBGYN (Obstetrics & Gynecology)
Endometrial cancer is diagnosed with a tissue biopsy. In this video, gynecologist Kristine Borrison, MD, of Good Samaritan Hospital explains the different ways doctors can take tissue samples. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.