Endometrial Cancer Initial Assessment

Clinical Presentation

The signs and symptoms of endometrial cancer are vaginal bleeding (90%); abdominal symptoms (eg pain, bloatedness, distention, change in bowel function); pelvic pain; early satiety; and change in bladder function.

Physical Examination

Screening

Screening is not routinely recommended except in symptomatic women and those at increased risk for endometrial cancer. Annual screening of high-risk women may be considered. For patients with Lynch syndrome, the following are recommended: Annual screening (with gynecological exam, transvaginal ultrasound, and aspiration biopsy) for individuals ≥35 years old; local progesterone therapy via Levonorgestrel intrauterine device (IUD); premalignant tumors should be treated; and prophylactic options, eg total hysterectomy-bilateral salpingo-oophorectomy (TH-BSO) should be discussed. Women of menopausal age should be advised to report any history of vaginal bleeding or spotting. Biopsy and transvaginal ultrasound are used for screening.