Don’t Ignore the Bleeding: What Every Woman Should Know About Uterine Cancer
A gynecologic oncologist, Dr. Ebony Hoskins, talks to Smart Patients about the most common gynecologic cancer and why it’s rising, typical symptoms, and how to best advocate for your health.
Most people have heard of ovarian cancer. Far fewer people realize that endometrial cancer, which is a type of uterine cancer, is the most common gynecologic cancer and has surpassed ovarian cancer incidence. In 2026, an estimated 68,270 new cases of uterine cancer will be discovered, and about 14,450 women will die. (Key Statistics for Endometrial Cancer | American Cancer Society.)
Unlike many other cancers, both new cases and deaths from uterine cancer are still increasing. That rise in diagnosis and death is the part Dr. Ebony Hoskins, a gynecological oncologist at Medstar Health, really wants women to hear. The numbers are climbing, she says. “That’s what people are missing.” For Uterine Cancer Awareness Month, we sat down with Dr. Hoskins to talk about five things she wants every woman to know.
1. There’s no screening test for uterine cancer
The single most important thing to understand is that “a Pap smear is used only to screen for cervical cancer,” Dr. Hoskins explains. Often women wrongly assume it catches other gynecological cancers too. It doesn’t. There is no routine screening test for uterine cancer currently.
That means no annual screening test will catch uterine cancer before symptoms appear. Recognizing the warning signs is the only early-detection strategy. Dr. Hoskins’ advice is simple: Watch and be mindful of your body, recognize the signs, and talk to your doctor.
2. The one sign to watch out for
The cardinal warning sign is simple and worth remembering:
“Postmenopausal bleeding is not normal. that’s what I tell people all the time.”
Any vaginal bleeding after menopause needs prompt evaluation.
Before menopause, the warning signs are bleeding between periods, unusually heavy or long periods, and pelvic pain. If irregular bleeding keeps happening, Dr. Hoskins says, “advocate for yourself to get a biopsy.”
The outlook is much better for uterine cancer that's caught early, which is why it's important to act promptly with any abnormal bleeding.
3. Inherited risk and when to ask about genetic counseling
Some uterine cancers run in families. “About 10 to 15% of uterine cancer is related to a genetic mutation,” Dr. Hoskins says. These uterine cancers tend to cluster along with colon cancers in the same family, so she says family history is something primary care and gynecologic providers should ask about at your annual exam, “especially if there’s any increased risk in the family.” If you have this kind of family history and it has never come up, bring it up yourself.
4. Why are cases rising?
The honest answer is that we don’t fully know yet. “We don’t have all the answers,” Dr. Hoskins says, “but obesity is one of the factors.” Rising obesity rates, increased estrogen exposure (closely linked to obesity), and an aging population are the leading suspects. But she is careful not to point to any single cause, noting there may well be factors not yet understood. Here is the full list of risk factors according to the American Cancer Society: Endometrial Cancer Risk Factors
5. What to expect at the visit, and how to advocate
If you have abnormal bleeding, talk about it and seek guidance but don’t panic. “Be aware of bleeding, but not every bleeding is cancer,” Dr. Hoskins says.
Dr. Hoskins says to start with your gynecologic provider. “If there’s a diagnosis or high suspicion of cancer, then you should be referred to a gynecologic oncologist.” A typical evaluation includes a pelvic ultrasound and an endometrial biopsy, or a D&C with hysteroscopy (a look inside the uterus using a thin, flexible camera tube). The diagnosis of uterine cancer depends on a tissue biopsy. Remember: there’s no screening test, but there are diagnostic tests once you have symptoms.
The one thing to remember from this article: Bleeding after menopause is never normal. Tell your doctor, and ask for an evaluation. No screening test will catch this for you, so noticing this sign and acting on it is what makes the difference.
This Uterine Cancer Awareness Month, the most powerful thing you can do is know the sign and share it with others.
If you’re facing uterine cancer, or caring for someone who is, join the Smart Patients endometrial cancer community to learn alongside people who understand. You don’t have to navigate it alone.