Stage 1 womb cancer

The stage of a cancer tells you how big the tumour is and how far it has spread. It helps your doctor decide which treatment you need.

Doctors use the International Federation of Gynecology and Obstetrics (FIGO) staging system for womb cancer. There are four stages, numbered 1 to 4.

Although a 2023 version of the FIGO system is available, doctors in the UK generally use the 2021 version.

Stage 1 cancers are early cancers and the easiest to treat. The cancer is within the womb. Stage 1 is divided into stage 1A and 1B.

  • 1A means that the cancer may have grown into the muscle wall (myometrium) of the womb, but less than halfway

  • 1B means the cancer has grown halfway or more into the muscle wall of the womb

Diagram showing stage 1 womb cancer


The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

  • the type of womb cancer you have

  • how the cancer is likely to behave (the grade)

  • the risk of your cancer coming back after surgery (low, intermediate, high-intermediate, high)

  • whether your cancer has any gene changes (mutations)

  • your general health

  • your preferences


Surgery is the main treatment for stage 1 womb cancer.

Your surgeon removes your womb and cervix. This is a simple or total hysterectomy. They usually also remove both of your fallopian tubes and ovaries. They may also remove nearby lymph nodes to check for cancer cells. This is called a sentinel lymph node Open a glossary item biopsy.

The surgeon who does the surgery is usually a specialist surgeon called a gynaecological oncologist.

Preserving fertility

Women who have low risk disease (stage 1A grade 1), have not been through the menopause and would like to have children may be able to have treatment that preserves their fertility. This means having treatment with hormone therapy.

You will need to have treatment in a specialist centre. This might not be your nearest hospital. This is not standard treatment so it is important to talk to your specialist about your options and the possible risks.

If you're not fit enough for surgery

If you are not fit enough for surgery, you might be able to have other treatments. The type of treatment will depend on your situation. You might have one of the following treatments:

  • vaginal hysterectomy for a low grade cancer

  • external and internal radiotherapy (brachytherapy) for a high grade cancer or internal radiotherapy only for a low grade cancer

  • hormone therapy for a low grade cancer to postpone surgery or if you can't have surgery or radiotherapy

Treatment after surgery

Treatment after surgery is called adjuvant treatment. It lowers the chance of the cancer coming back.

Treatment is usually with chemotherapy or radiotherapy. Radiotherapy uses high energy rays similar to x-rays to kill cancer cells. Chemotherapy uses anti cancer drugs to destroy cancer cells.

Low risk

You might not need adjuvant treatment if you have a very early cancer that has a low risk of coming back. This is generally stage 1A, and the cells don't look very abnormal. This means it is grade 1 or 2 cancer.

Intermediate risk

You usually have internal radiotherapy (brachytherapy) if you have an intermediate risk cancer and your cancer is one of the following:

  • stage 1A grade 3 cancer
  • stage 1B grade 1 to 2 cancer

High-intermediate risk

If you have a high-intermediate risk stage 1A, or stage 1B grade 3 cancer, you may have one of the following treatments after surgery;

  • external radiotherapy – this is the most common treatment after surgery
  • chemotherapy with radiotherapy or chemotherapy followed by radiotherapy, or both
  • internal radiotherapy instead of external - this is sometimes considered if the risk is lower and lymph nodes that were removed during surgery are clear of cancer

High risk

After surgery you may have one of the following:

  • external radiotherapy with chemotherapy and then more chemotherapy
  • chemotherapy followed by radiotherapy
  • chemotherapy on its own

If you have a carcinosarcoma, your treatment is the same as treatment for high-risk womb cancer.

Other stages

  • Cancer of the corpus uteri (2021 update)

    M Koskas and others 

    International Journal of Gynaecology and Obstetrics, 2021. Volume 155, Supplement S1, Pages: 45 to 60

  • British Gynaecological Cancer Society (BGCS) uterine cancer guidelines: recommendations for practice

    J Morrison and others

    European Journal of Obstetrics and Gynecology and Reproductive Biology, March 2022. Volume 270, Pages 50 to 89

  • Endometrial cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up
    A Oaknin and others
    Annals of Oncology, 2022. Volume 33, Issue 9, Pages: 860 to 877 

Last reviewed: 
25 Mar 2024
Next review due: 
25 Mar 2027

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