Did You Know a Pap Smear Doesn’t Screen for Uterine Cancer?

By Corrie Pellegrino - June 12, 2023

Uterine cancer is the fourth most common cancer in women, after breast, lung and colon cancer. Most women assume the standard Pap smear screens for it. Unfortunately, that’s a myth.

“A Pap smear is the screening test for cervical cancer and will miss a majority of the endometrial cancers,” explained Mian Shahzad, M.D., Ph.D., a gynecologic oncologist at Moffitt Cancer Center. Endometrial cancer is the most common type of uterine cancer, and it can be detected by a simple office biopsy.

Shahzad and his colleagues in Moffitt’s Gynecologic Oncology Department are working to raise awareness about uterine cancer as rates are on the rise across the United States. The International Gynecologic Cancer Society has declared June as Uterine Cancer Awareness Month to help combat the epidemic and promote education, research and equitable access to care.

In 2023, more than 66,000 women in the United States are expected to be diagnosed with uterine cancer, a number that has been steadily increasing over the past 10 years, Shahzad points out. Compared to the rest of the world, North America is seeing one of the highest rates of uterine cancer.

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"As low- and middle-income countries increase their per capita income, the rates of uterine cancer go up as well because there’s more availability of food and increased caloric intake, resulting in obesity."

- Mian Shahzad, M.D., Ph.D., Gynecologic Oncology Program

“This is mostly because of obesity,” he said. “As low- and middle-income countries increase their per capita income, the rates of uterine cancer go up as well because there’s more availability of food and increased caloric intake, resulting in obesity.”

In women who are obese, fatty tissue cells convert hormones into a type of estrogen that then stimulates the inside lining of the uterus, known as the endometrium. Excessive estrogen levels are the cause of endometrial cancer in a vast majority of the cases.

Post-menopausal women are most at risk for uterine cancer. In 90% of cases, the first sign is vaginal bleeding. Another common sign is pyometra, or an infection in the uterus. The key is to take action at the first sign of a problem.

“A post-menopausal woman who has any kind of spotting or bleeding needs to be further evaluated,” Shahzad said. A gynecologist can perform the initial biopsy. If there are any signs of precancerous or cancerous cells, the patient should see a gynecologic oncologist.

A hysterectomy along with removal of both tubes and ovaries, as well as lymph node sampling, is standard treatment for uterine cancer. However, there are several treatment options for younger patients that can help preserve their ovarian function or even fertility. Moffitt works with patients of all ages to determine the best treatment options for their circumstances after appropriate evaluation.

The most important fact to know, Shahzad emphasized: “If caught early, it is fully treatable and, in most cases, curable.”

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Corrie Pellegrino Senior Managing Editor 813-745-0833 More Articles

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