Uterine Cancer Is Increasing In All Women — And Black Women Are At Highest Risk

When you think of the most common gynecological cancer, you probably don’t think of uterine cancer, but this cancer type is more commonly diagnosed than other gynecological cancers such as ovarian and cervical.

There were nearly 70,000 cases of uterine cancer in 2024, according to the National Cancer Institute.

Uterine cancer involves cancer of what many folks think of as the womb, “or the place where a pregnancy is housed and grows,” said Dr. Ami Vaidya, a gynecological cancer doctor at Hackensack Meridian Health in New Jersey.

“The uterus has two components; there’s a muscle wall and there’s a lining, an inner portion of the uterus that consists of glandular tissue,” Vaidya explained.

“And I mentioned these two different areas because very different cancers can start in the two different areas of the uterus,” she noted.

It’s more common to see cancer in the lining, which is known as endometrial cancer, Vaidya said. “And although there are several different types within that category, as a group, that is more common than the cancers that can start in the muscle wall — the cancers that start in the muscle wall are called sarcomas or leiomyosarcomas,” she said.

Uterine cancer rates are rising, said Dr. Ebony Hoskins, a gynecologic oncologist in Washington, D.C., and member of the Society of Gynecologic Oncology.

Rates of endometrial cancer, specifically, have actually surpassed ovarian cancer rates. This makes it the most common GYN cancer in the country, Hoskins added.

Roughly 12,000 people die of ovarian cancer each year while more than 13,000 die of endometrial cancer, said Hoskins. Here’s what to know:

While screening tests like mammograms screen for breast cancer and pap smears screen for cervical cancer, there isn’t an equivalent for uterine cancer.

“We don’t have a test to predict early disease or pre-invasive disease,” said Hoskins. This makes it crucial to understand the warning signs of this kind of cancer and who it commonly occurs in.

“It’s typically detected in post-menopausal women, so women after the age of menopause, after they’ve not had a cycle for greater than one year,” said Hoskins.

Uterine cancer is most common in this population, which tends to be women over the age of 50. In women who have gone through menopause, the sign of uterine cancer is often post-menopausal bleeding, she noted.

“If they suddenly start bleeding, they should call their gynecologist or their health care provider and say, ‘This is what’s going on,’ and that doctor, then, in turn, should see and examine the patient,” added Vaidya.

Pelvic pain or discomfort is also a red flag, Hoskins said.

The doctor may order testing to look at the uterus, such as an ultrasound, and will likely also do a biopsy on tissue from the uterus, said Vaidya.

“Those are the ways that, if someone’s having symptoms, that we can try to test and look for it,” Vaidya said.

The cancer isn’t as common in pre-menopausal women, but it can still happen, said Hoskins. Symptoms in this group include irregular heavy bleeding or bleeding between periods, Hoskins added.

This doesn’t mean that any period irregularity or heavy bleeding is cancer, though, so, don’t panic, said Vaidya. There can be many common reasons for heavier or irregular periods such as fibroids or a polyp, she noted.

“But it does make sense for women to think about their body, to notice if there’s a change, and especially when we think of pre-menopausal women … it is good, if you’re familiar with your normal [cycle] to then be able to report an abnormal [cycle],” Vaidya said.

A few groups of people are at higher risk for developing uterine cancer, and while this includes Black women (more on that below), it also includes other folks.

You can genetically be at higher risk of uterine cancer, too, said Hoskins. “Folks may have something called Lynch syndrome … basically they’re born with the gene that puts them at risk,” said Hoskins.

In this case, if you have a family history of colon, ovarian or uterine cancer, you should let your doctor know, both experts told HuffPost. You could be eligible for genetic testing to see if you have Lynch syndrome.

People who have PCOS, or polycystic ovary syndrome, are also at higher risk, noted Vaidya.

Taking unopposed estrogen also puts folks at higher risk. Hoskins explained what that means: “Any woman with a uterus needs to have estrogen and progesterone — that helps counterbalance any type of effect on the endometrium,” Hoskins said.

It’s common for women to take hormone therapy to counteract menopause symptoms.

“I think most providers know that you need to not just prescribe estrogen, but estrogen and progesterone to protect the uterus, if they’re using any type of hormone replacement,” Hoskins noted.

If you are prescribed hormone replacement pills, be sure to follow the directions from your provider, and don’t skip out on your progesterone medication, Hoskins added.

Recent research out of Columbia University and published in the American Association for Cancer Research used current data and modeling tools to predict what uterine cancer rates and mortality may look like in 30 years — and it paints a bleak picture.

“I thought it was scary,” said Hoskins. In 2050, it’s expected that uterine cancer incidence and deaths will increase. Uterine cancer cases are expected to increase by 50% in Black women in 2050 and 29% in white women when compared to 2018 data.

Currently, “Black women may be diagnosed at the same rate as white women, but are two times more likely to die,” according to Hoskins.

The exact reasons why Black women are at higher risk aren’t known, but Hoskins has a few ideas.

“In endometrial cancer, there’s about eight different subtypes [and] Black women tend to have cancers that are more aggressive,” said Hoskins.

Systemic racism could also be a reason — maybe the patient wasn’t heard by their doctor, Hoskins noted, or perhaps they didn’t have swift access to care.

“There are some things that I do think need to be studied more, but we should discuss it, and that may be use of relaxers … as a potential risk,” said Hoskins, referring to recent research showing that the chemicals in hair-straightening relaxers put folks at higher risk of uterine cancer. Synthetic hair used by Black women for hair braiding has also been found to be carcinogenic.

“The main driving force for why we’re seeing an uptick in younger women — and that’s across the board, white, Black [and other groups] — has to do with increase in hormones that are influencing the uterus in obese patients,” said Vaidya.

How so? “The majority of our hormones we’re talking about — estrogen and progesterone — come from the ovary in pre-menopausal women,” said Vaidya.

“In pre-menopausal women, we expect to see a balance between estrogen and progesterone when they’re made by the ovary,” she noted.

In obese folks, “fat cells produce something called estrone. It is a weak estrogen, and fat cells don’t produce the balancing hormone progesterone at all. So for patients who are obese, who are over their ideal body weight, those patients will have estrone in their body that stimulates the lining of the uterus, and because they don’t have the balanced progesterone from those same fat cells over time, those are women that are at increased risk for developing this endometrial pre-cancer and endometrial cancers,” explained Vaidya.

It’s important to note that obesity itself isn’t an indicator of one’s health, but there are cases, like this one, when it can impact chances of developing certain diseases. And in this case, Vaidya added that the more overweight someone is, the higher their risk is for uterine cancer.

This all may sound scary, but understanding the risk factors and the signs of uterine cancer can help you take control of your health and know when to bring a specific issue to your doctor’s attention.