Revised June 2011

Screening procedures in asymptomatic high risk patients have not resulted in any demonstratable benefit, although endometrial biopsy may be used to follow the response to institution of progestins in patients known to have hyperplasia.

Women on tamoxifen have an increased risk. Those who develop abnormal uterine bleeding need endometrial sampling.

Patients with endometrioid ovarian cancers and adult granulosa cell tumors of ovary have an increased risk for endometrial cancer and hysterectomy is recommended routinely as part of their management. If fertility preservation is important please discuss with gynecologic oncologists at BCCA.

It must be emphasized that Pap smear is not a satisfactory screening procedure for endometrial cancer and that all cases of post-menopausal and intermenstrual bleeding or spotting require investigation and endometrial tissue sampling. Post-menopausal women who develop a sudden onset of an unusual vaginal discharge in the absence of an identifiable vaginal cause may be suffering from endometrial cancer and require similar investigation. A variety of techniques are available to evaluate patients including endometrial biopsies, hysteroscopy and fractional D&C.

NB: A normal endometrial thickness on ultrasound does not rule out endometrial cancer.