Tests for Uterine Cancer

Pelvic exam. Your doctor checks the size of the uterus and feels for lumps. An enlarged uterus, other than in pregnancy, is a possible sign of endometrial or uterine cancer.

Pap tests obtain cells from the upper vagina and cervix. In rare cases, cancer cells from the endometrium (above the cervix) are included in the Pap sample.

Transvaginal ultrasound. In this test, a probe using sound waves to bounce off pelvic organs is inserted into the vagina up to the cervix. This device produces images of the lining of the uterus and of irregular surfaces to help determine if tumors are present.

D&C (dilation and curettage). After the patient is given either local or general anesthesia, the doctor dilates the cervix and inserts a spoon-like tool to remove (scrape) samples of the endometrial tissue and the source of bleeding. Tissue samples are sent to the pathology lab for examination under the microscope to see if the bleeding is due to cancer or some other condition, such as endometrial hyperplasia.

Hysteroscopy. Sometimes an area of cancer in the endometrium may be left behind after a D&C. A hysteroscopy is performed to provide a detailed view inside the uterus. A local or general anesthesia is given. The cervix is dilated and a fiber-optic scope is inserted into the uterus to view the inside for polyps, fibroids or any other suspicious areas that should be biopsied.

An endometrial biopsy is done in cases where the D&C is not appropriate or if an area suspicious for cancer is seen on hysteroscopy. In some cases, several areas are sampled for biopsy. An endometrial biopsy, even if multiple areas are sampled, removes much less tissue than the D&C and is usually quicker and less complicated.

In all cases where tissue is removed, a pathologist will examine the specimen to look for evidence of cancer. It can take several days to obtain test results.

CA-125 blood test. In most instances, staging for cancer of the uterus will include additional blood work, including the CA-125 blood test. CA-125 ("CA" stands for cancer) is a protein produced by the ovaries, fallopian tubes and the uterus. If elevated, the CA-125 helps in diagnosing advanced endometrial cancer.

In order to look for spread of endometrial cancer, the physician may also order a pelvic computed tomography (CT) scan or magnetic resonance imaging (MRI) scan, a cystoscopy (examination of bladder), a colonoscopy or a sigmoidoscopy (examination of the bowel).

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This article was reviewed and updated June 2007.