Womb cancer tests
This page tells you about tests to diagnose womb cancer. You can find the following information
Womb cancer tests
You will usually see your family doctor (GP) first, who will ask you about your general health and examine you. If you have symptoms that may be caused by womb cancer, your GP may ask about your family history of cancer. They may ask you to give blood and urine samples for testing. Your GP will probably then do a pelvic examination (sometimes called an internal). They may also take a sample of cells from the surface of the neck of the womb (a cervical smear).
At the hospital
If your doctor is at all concerned, they will ask you to go to the hospital for tests. The only way to definitely diagnose womb cancer is to take a sample of the tissue lining the womb (an endometrial biopsy). Your doctor sends the tissue to the lab, where it is closely checked for cancerous cells, or cells that look abnormal in any way. There are different ways to take these biopsies. You might have an aspiration biopsy, a hysteroscopy, dilatation and curettage (a D and C) or other tests.
While you are waiting for results, it may help to talk to a close friend or relative about how you are feeling. Or you may want to contact a support group to talk to someone who has been through similar experiences.
You can view and print the quick guides for all the pages in the diagnosing womb cancer section.
If you have any health worries, you will usually see your family doctor (GP) first. They will ask you about your general health and examine you. If you have symptoms that may be caused by womb cancer, your GP may ask about your family history of cancer. They may ask you to give blood and urine samples for testing.
Your GP will probably then do a pelvic examination to check your womb, vagina, ovaries and bladder. This is sometimes called an internal. You lie on your back on a couch with your feet drawn up and your knees apart. Your doctor will then put one or two gloved fingers into your vagina and at the same time press down on your abdomen with the other hand. As part of the examination, your doctor may check your rectum (back passage). For this, you will lie on your side. The doctor will feel for any lumps or changes in size or shape. If any part of your reproductive system is enlarged, or if a lump of any kind is there, the doctor should be able to feel it.
Your GP may use an instrument called a speculum to spread the vaginal walls and examine the neck of the womb (cervix), to see if it looks normal. They may also take a sample of cells from the cervix. This is a quick procedure that should only be uncomfortable for a very short time. The whole internal examination will probably take about 5 minutes.
If your doctor is at all concerned, they will ask you to go to the hospital for tests. Some hospitals have specialist post menopausal bleeding clinics where you may have all the tests you need in one day. In other hospitals, you may see a gynaecologist first for an assessment. You then go back to hospital another day for tests. The main tests for possible womb cancer are transvaginal ultrasound and biopsy.
You usually have the ultrasound probe put inside your vagina. This is called a transvaginal ultrasound. It may feel uncomfortable but should not hurt. You will be asked to empty your bladder before this test. Instead of a transvaginal ultrasound you might have the probe on your tummy (abdominal ultrasound). Sometimes your doctor may ask you to have both types of ultrasound.
If the lining of your womb is thicker than normal or there are other abnormal signs, you will need further tests.
The only way to definitely diagnose womb cancer is to take a sample of the tissue lining the womb (an endometrial biopsy). The tissue sample is sent to the lab where it is closely checked for cancerous cells, or cells that look abnormal in any way.
There are different ways to take these biopsies. You might have
To have this test you lie on a couch and the doctor or nurse will open your vagina with a speculum. This is just the same as when you have a cervical screening test (smear test). The doctor puts a long thin tube into your womb through the vagina. With gentle suction, they draw some of the cells lining the womb into the tube. Most women can have this procedure while they are awake. It should only take a few minutes. The doctor sends the sample of cells to the lab to be looked at by a pathologist.
You may have period type pains during or after this test, but mild painkillers should help to control any pain.
This test uses a fine telescope called a hysteroscope. It allows your doctor to look into your womb and take a biopsy. You can have this test as an outpatient, and it should only take a few minutes.
Your doctor will gently put a speculum into your vagina to keep it open. They will put local anaesthetic around your cervix (neck of womb) to reduce any discomfort you may have during the test. Then your doctor passes the hysteroscope through your cervix into your womb. To make it easier to see inside, your doctor will put some fluid or gas through the hysteroscope to inflate the womb a little. The doctor will examine your womb and take a sample of the lining. They send this sample to the lab to check for cancer cells.
During and after this test you might have some cramping pains, similar to period pains, but mild painkillers should help. You may also have some bleeding which lasts a few days.
In some cases, you may need to have a D and C so that your doctor can get enough tissue for testing. You have this done in hospital while you are asleep (under general anaesthetic). This procedure has 2 parts. Firstly, your doctor opens up (dilates) the entrance to your womb (the cervix). They may look inside your womb with a hysteroscope. They then gently scrape away samples of the womb lining with a small spoon like instrument called a curette. They send the tissue samples to the laboratory for examination under a microscope.
You will need to stay in hospital to recover for at least a few hours after a D and C. Some women may need to stay overnight.
You will have blood tests to check your general health. Your doctor may also test for CA125. This is a tumour marker. A tumour marker is a chemical given off by cancer cells. It gets into the bloodstream and so can be picked up in a blood test. The blood levels of CA125 are raised in some women with either ovarian or womb cancer, but not all. If you have raised CA125 levels in the blood it does not necessarily mean you have cancer. CA125 can also be raised in a number of non cancerous conditions, including fibroids.
Sometimes blood tests can show that you are suffering from anaemia (low blood iron content) because you are losing blood from abnormal or heavy vaginal bleeding.
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