Endometrial carcinoma

Endometrial carcinoma is the most common gynaecological cancer in the developed world.

• carcinoma of the endometrium is responsible for around 92% of the cancers of the uterine corpus (the remainder being uterine carcinosarcomas and sarcomas)
• it is predominantly a disease of post-menopausal women which makes up around 90% of all women diagnosed as having endometrial carcinoma
  • mean age at diagnosis is around 63 years

Endometrial carcinoma can be divided histopathologically into 2 major types:

• type 1 cancers
  • account for 80-90% of endometrial carcinomas
  • usually oestrogen dependent endometrioid adenocarcinomas
  • generally have a good prognosis.
• type 2 tumours
  • usually present late and are more aggressive
  • carry a poor prognosis
  • not oestrogen driven
  • risk of relapse and metastasis is high
  • commonest histological types are uterine papillary serous carcinoma and clear cell carcinoma

UK Uterine Cancer Statistics (2):

• are around 10,100 new uterine cancer cases in the UK every year, that's 28 every day (2018-2019,2021)
• uterine cancer is the 12th most common cancer in the UK, accounting for 3% of all new cancer cases (2018-2019,2021)
• in females in the UK, uterine cancer is the 4th most common cancer, with around 10,100 new cases every year
• since the early 1990s, uterine cancer incidence rates in females have increased by three-fifths (60%) in the UK (2018-2019,2021)
• over the last decade, uterine cancer incidence rates in females have increased by around a twentieth (6%) in the UK (2018-2019,2021)
• uterine cancer is the 18th most common cause of cancer death in the UK, accounting for 2% of all cancer deaths (2022-2024)
• in females in the UK, uterine cancer is the 7th most common cause of cancer death, with around 2,700 deaths every year
• mortality rates for uterine cancer in the UK are highest in females aged 90+ (2022-2024)
• each year more than half (53%) of uterine cancer deaths in the UK are in people aged 75 and over (2022-2024)
• more than 7 in 10 (71.7%) females diagnosed with uterine cancer in the UK survive their disease for ten years or more, it is predicted (2018)
• 8 in 10 (80.1%) females in the UK diagnosed with uterine cancer aged 15-44 survive their disease for ten years or more, compared with almost 6 in 10 (54.8%) females diagnosed aged 75-99 (2018)
• incidence rates for uterine cancer are higher in the Black ethnic group, lower in people of mixed or multiple ethnicities, and similar in the Asian ethnic group, compared with the White ethnic group, in females in England (2013-2017)

Summary points (3):

• early-stage, low-risk disease is managed with observation after surgery
• patients with early-stage, high-intermediate risk disease typically undergo adjuvant radiation therapy and patients with aggressive histologic subtypes or advanced-stage disease are treated with adjuvant chemotherapy
• first-line chemotherapy for advanced-stage endometrial cancer is carboplatin and paclitaxel plus consideration of anti–programmed cell death protein 1 immunotherapy
• radiation therapy is used for localized recurrences in the pelvis; distant or multifocal recurrences are treated with systemic therapy, including chemotherapy, without or with immunotherapy, or hormonal therapy such as progestins or antiestrogens
• five-year survival is greater than 86% for stage I endometrial cancer, greater than 75% for stage II, greater than 41% for stage III, and greater than 18% for stage IV disease

The overall prognosis is relatively good as most cases are caught early following investigation for post-menopausal bleeding. Nulliparous women and those of low parity seem to be affected most frequently.

Reference:

• (1) Saso S et al. Endometrial cancer. BMJ. 2011;343:d3954
• (2) CRUK. Uterine Cancer Statistics (Accessed 15/4/26)
• (3) Mager KL, McLean K. Endometrial Cancer: A Review. JAMA. Published online April 13, 2026.