Study suggests more educational intervention is needed to help women spot signs of endometrial cancer

Despite the fact that endometrial cancer is the most common cancer of the female reproductive organs, a significant percentage of women do not know that postmenopausal bleeding is a key warning sign of the disease.

Worse, even fewer women report having received any type of counseling on the subject from their health care professionals. That's according to a new study, "Public awareness and provider counseling regarding postmenopausal bleeding as a symptom of endometrial cancer," published online in Menopause.

It is estimated that 67,880 new cases of uterine cancer will be diagnosed in 2024, with roughly 13,250 related deaths.

Of greater concern is the more than 2% increase in incidence per year in nearly every racial/ethnic group—an increase that is partially because of increasing rates of obesity in the United States. Death rates related to endometrial cancer are also increasing—approximately 1.1% per year from 1999 to 2016.

Although there is no screening test for endometrial cancer, diagnosis frequently occurs at an early stage because the disease is accompanied by such detectable symptoms, such as abnormal and postmenopausal bleeding.

When symptoms are diagnosed at an early stage, the 5-year survival rate is nearly 95%. If not recognized and diagnosed in time, the cancer may progress and metastasize, resulting in the much lower survival rate of less than 19%.

Despite its easily recognizable symptoms, many women go undiagnosed because they don't know that postmenopausal bleeding is a symptom of endometrial cancer—even if the bleeding only occurs once.

A new study based on nearly 650 participants, 145 of whom were postmenopausal, showed that more than one-third of survey participants (37%) did not recognize postmenopausal bleeding as a key symptom, and 41% said they would not tell their health care professional if they had postmenopausal bleeding after only one episode.

Part of the problem results from too few women (only 46.5% in the current study) even understanding the correct definition of menopause, which is not having had a period for one year or more.

Health care professionals appear to also be lacking adequate education, because less than 50% of surveyed women reported that their health care professional had counseled them on postmenopausal bleeding.

Such abysmal numbers suggested to researchers that there is a need for improved education of patients and clinicians, as well as improved patient counseling regarding endometrial cancer and signs and symptoms to watch out for.

"This survey study highlights opportunities for improved patient counseling about abnormal and postmenopausal uterine bleeding as an early warning sign of uterine cancer. This is especially important given that the incidence and mortality rates of uterine cancer continue to increase and are notably highest in women of color," says Dr. Stephanie Faubion, medical director for The Menopause Society.