Uterine cancer vaginal bleeding

Uterine Cancer: What Are The Risk Factors?

Uterine cancer is the fourth most common cancer among women in Singapore, with 70% of cases occurring after the age of 50 years, and commonly diagnosed due to abnormal bleeding especially after menopause.

(As most uterine cancers develop from the endometrium, the term “endometrial cancer” may sometimes be used interchangeably with uterine cancer although there are differences)

Although abnormal vaginal bleeding may not always be indicative of cancer, those at a higher risk of developing uterine cancer should consider going for annual screenings. If detected at an early stage, the five-year survival rate for uterine cancer is as high as 95%.

Risk Factors of Uterine Cancer

  • Obesity
  • Diabetes
  • Women who have never been pregnant
  • Women who had their first periods by age 12; and women who have undergone menopause after age 55
  • Irregular or infrequent menstrual periods of less than 4 times a year
  • Women with Polycystic Ovarian Syndrome (PCOS)
  • Family history of uterine cancer
  • Personal history of breast or ovarian cancer
  • Hormone Replacement Therapy that involves only Oestrogen
  • Use of contraceptive Intrauterine Devices (IUDs)

Signs and Symptoms

The most common symptom of uterine cancer is unusual vaginal bleeding. While vaginal bleeding is not always a sign of cancer, it is recommended that a doctor be consulted as this could indicate other problems as well.

Unusual vaginal bleeding includes:

  • Bleeding after menopause
  • Bleeding between menstrual periods
  • Abnormally heavy periods

Other signs of uterine cancer are:

  • Vaginal spotting
  • Pink or white water vaginal discharge
  • Vaginal discharge that has a foul odour
  • Pain during or after sexual intercourse
  • Painful urination
  • Pelvic pains

Screening and Diagnosis

Women who are at higher risk of developing uterine cancer should consider going for annual screenings of uterine cancer with transvaginal ultrasound and endometrial biopsy by the age of 30-35.

Primary evaluation in the doctor’s office may involve a pelvic examination to detect lumps or unusual findings, as well as an ultrasound scan to identify abnormalities in the uterus.

Endometrial Biopsy

A thin tube is inserted through the cervix into the uterus to obtain a small amount of uterine tissue. This biopsy is necessary to confirm the diagnosis of uterine cancer.

Dilatation and Curettage (D&C) may also be performed to remove the uterine tissue for testing, to determine the progress of uterine cancer prior to treatment

Surgery is the most common form of treatment for uterine cancer

Treatment for Uterine Cancer

1. Surgery

This is the most common form of treatment for uterine cancer that removes the uterus and cervix. If the cancer has spread, the ovaries, fallopian tubes and lymph nodes may be removed too.

2. Radiotherapy

This can be used in all stages of uterine cancer, where high-energy rays target the cancer calls. It may also be introduced before surgery, or after to remove remaining cancer cells.

3. Chemotherapy

Usually given after surgery, drugs are administered either intravenously (IV) or taken orally in a pill/capsule. Sometimes, the chemotherapy treatment plan may involve a combination of drugs to improve the success rate of the treatment. Read about caring for a loved one going through Chemotherapy here.

4. Hormone Therapy

Aimed at slowing the growth and development of some types of uterine cancer, this is usually given by an oral pill containing a sex hormone called progesterone, which helps to balance out the hormone levels in the body.

This article is part of our Gynaecological Cancers series. To know more about other Gynaecological Cancers, continue reading about Ovarian Cancer and Cervical Cancer.


  1. Singapore Cancer Society (2016). Uterine Cancer. Retrieved from https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/uterine-cancer.html
  2. Singhealth Group. (2019). Uterine Cancer. Retrieved from https://www.singhealth.com.sg/patient-care/conditions-treatments/uterine-cancer
  3. The Straits Times (2016, March 29). High survival rate for uterine cancer if detected early.  Retrieved from https://www.straitstimes.com/singapore/health/high-survival-rate-for-uterine-cancer-if-detected-early
  4. Cancer Research UK (2017, September 3). Womb Cancer – Risks and Causes. Retrieved from https://www.cancerresearchuk.org/about-cancer/womb-cancer/risks-causes

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