Uterine cancer: What to watch for, and what else it could be

About 68,270 people will be diagnosed with uterine cancer in the US in 2026, making it the most common cancer of the female reproductive system.

Unlike some cancers, uterine cancer usually comes with an early warning sign: abnormal bleeding.¹ That may be why about 67% of cases are found while the cancer is still confined to the uterus, when it's more treatable.² But bleeding, cramping, and pelvic pressure are also common symptoms of several less serious uterine conditions—and knowing what else could be behind them helps you own your health.³ Here’s what to watch for, what else it could be, and how lab tests and MRI can help you get a clearer view of your uterine health.

Key facts

• Five-year survival is 94.9% for localized uterine cancer, dropping to 19.9% once it has spread beyond the uterus.⁴
• Obesity, age over 60, and conditions that raise estrogen exposure are among the strongest risk factors.⁵
• There's no USPSTF-recommended population-level screening program for uterine cancer.⁶

Understanding uterine cancer

Uterine cancer usually starts in the endometrium, the tissue lining the uterus—this is also called endometrial cancer, and it's by far the most common type. A rarer type, called uterine sarcoma, starts in the muscle wall of the uterus instead. Anyone with a uterus can develop uterine cancer, though certain factors raise your risk:

• Age:⁷ Most cases are diagnosed after age 60, and risk climbs the older you get.
• Weight: Higher body fat increases estrogen levels, which can drive cell growth in the endometrium.⁸
• Hormonal history: Never having given birth, an early first period, late menopause, and long-term unopposed estrogen use are all linked to higher risk.⁸
• Diabetes: Insulin resistance is associated with increased risk.⁸
• Genetic factors: Lynch syndrome, a hereditary condition, raises the risk of uterine cancer along with colorectal and ovarian cancers.⁸

Having one or more of these factors doesn't mean you'll develop uterine cancer, and having none doesn't rule it out. Paying attention to symptoms, not just risk factors, matters.

What else could it be?

Bleeding, pelvic pain, and pressure overlap with several uterine conditions that are more common than cancer.

Uterine fibroids

Fibroids are benign growths in the muscle wall of the uterus, and they're the most common uterine condition overall.⁹ Only about 1 in 3 cases cause noticeable symptoms, which can include heavy or prolonged bleeding, pelvic pressure, constipation, and fertility problems.⁹ Fibroids range from a few millimeters to more than 20 centimeters, and size often affects how symptomatic they are.¹⁰

Endometriosis

Endometriosis happens when tissue similar to the uterine lining grows outside the uterus, often on the ovaries, fallopian tubes, or bowels.¹¹ It's most often diagnosed in your 30s and 40s, though it can affect anyone who menstruates. Common signs include pelvic pain, painful periods, pain during sex, and infertility.¹¹

Tilted uterus

A retroverted, or tilted, uterus curves backward instead of forward. It's often symptom-free, but for some people it causes painful sex, severe cramps, or lower back pain during periods.¹² Treatment usually isn't needed unless symptoms are significant.

Uterine prolapse

Uterine prolapse occurs when weakened pelvic muscles let the uterus drop into the vaginal canal. It's linked to multiple vaginal deliveries, aging, menopause, and chronic constipation or coughing.¹³ Signs include a feeling of fullness or bulging in the vagina, urinary issues, and lower back pain.¹³ Pelvic floor exercises, pessaries (a small device inserted into the vagina to support the uterus), and surgery are all treatment options depending on severity.

Chronic pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a persistent bacterial infection affecting the uterus, fallopian tubes, and ovaries. Signs include ongoing pelvic pain, abnormal discharge, irregular bleeding, and pain during sex. Left untreated, it can lead to infertility and chronic pain, which is why early antibiotic treatment matters.¹⁴

Why the warning signs are important

Bleeding is a strong clue because abnormal bleeding is a common signal of uterine cancer. More than 90% of people diagnosed with uterine cancer experienced vaginal bleeding beforehand, and that's especially true for bleeding after menopause, which is never considered normal and always worth evaluating.¹⁵

But most bleeding after menopause isn't cancer. Only about 9% of people with postmenopausal bleeding are ultimately diagnosed with uterine cancer.¹⁵ The rest are often dealing with causes such as vaginal or endometrial thinning, polyps, or fibroids. ¹⁶This symptom shouldn't be ignored, but it also shouldn't cause panic on its own.

Why catching it early changes the outlook

Catching uterine cancer early can make a real difference. When it's still confined to the uterus, the large majority of people are still alive five years later²˒⁴. Once it's spread to other parts of the body, that outlook drops sharply—to less than 1 in 5²˒⁴. Early cancers also tend to need less aggressive treatment¹⁷˒¹⁸. That's the real reason the warning signs are worth acting on right away, instead of waiting to see if they go away on their own.¹⁷

What you can do

• Talk to your care team about unusual bleeding: Mention any bleeding after menopause, or bleeding between periods before menopause to your doctor.
• Know your risk factors: Understanding your personal risk, including your weight, hormonal history, and family history of Lynch syndrome or related cancers, is powerful information for you and your doctor.

Imaging offers an additional view

A clinical workup for uterine cancer usually starts once symptoms appear. But you don't have to wait for symptoms to get a better understanding of your uterine health.

Function members have access to 160+ lab tests, including hormones such as Follicle Stimulating Hormone, Luteinizing Hormone, and Estradiol. These tests don't diagnose uterine cancer, but they can offer a better understanding of hormone patterns.

Function members also have access to member pricing for the Annual MRI, which can look for signs of conditions like uterine fibroids and uterine cancer, along with other conditions across multiple organs. It’s designed to screen, not diagnose. If something looks unusual, your clinician can help you decide what to do next. Together, lab tests and an Annual MRI give you a more detailed view of your uterine health that you can track year over year, rather than waiting for symptoms.