Uterine Cancer Diagnosis and Prognosis

Initial uterine cancer diagnosis involves an internal pelvic examination and a Pap smear. A Pap smear is useful for establishing the presence of abnormal cells. However, as endometrial cancer originates in the uterus, a Pap smear is unlikely to detect the presence of uterine cancer. In fact, more than fifty percent of cases of cancer of the uterus show normal Pap results.

 

The Pap smear is, however, the standard method of screening for cancers of the cervix—the lowest part of the uterus. Follow the link to learn more about cervical cancer and the Pap smear.

TVUS (transvaginal ultrasound) may be used to determine abnormal thickening of the uterus. As with the Pap smear, TVUS has limited value for diagnosing endometrial cancer.

Additional testing is required to diagnose endometrial cancer. Specific tests for uterine cancer diagnosis include:

Endometrial Biopsy: Endometrial biopsy for uterine cancer involves inserting a very thin, flexible tube, through the cervix into the uterus to remove a small sample of endometrial tissue.

D & C (Dilatation and Curettage): If an endometrial biopsy fails to remove sufficient cell tissue, or the doctor suspects a diagnosis of uterine cancer, a D & C is performed to diagnose endometrial cancer, where the cervix is dilated and a sample of endometrial cells is scraped from the uterus lining to rule-out or confirm a uterine cancer diagnosis.

Following a uterine cancer diagnosis, the malignant endometrial cells are then further analyzed to evaluate the grade and extent or "stage" of endometrial cancer. Individual prognosis depends upon the grade, spread and type of uterine cancer. In general, prognosis for endometrial cancer is better than other types of malignancy of the female reproductive organs, such as cervical cancer or ovarian cancer.

Diagnosis of endometrial cancer is typically made in the early stages of the disease. Diagnosis of approximately 70 to 75 percent of cases is confirmed as Stage I, 10 to 15 percent as Stage II, and the remaining 10 to 15 percent as Stages III and IV.

Staging for endometrial cancer involves a surgical laparotomy to examine the pelvic and abdominal areas for spread of uterine cancer.

Uterine cancer stages are determined by tumor depth and spread. Endometrial tumors are graded according to the cancerous cells' composition, maturity and activity, and the extent to which they differ from normal cells. A high degree of cell maturity points to an improved prognosis.