Cervical Cancer vs Endometrial Cancer

Cervical cancer and endometrial cancer are two of the most common gynecologic cancers. Although they both affect the female reproductive system, they differ in where they start, who is most at risk, how they’re diagnosed, and how they’re treated. Understanding these differences can help you recognize warning signs, know which screenings to discuss with your doctor, and make informed decisions about your health.

---

What Is Cervical Cancer?

• Origin
  Cervical cancer begins in the cells lining the cervix, the lower part of the uterus that connects to the vagina.

• Main Cause
  Most cases are caused by persistent infection with high-risk types of human papillomavirus (HPV), a common sexually transmitted virus.

• Age Group
  Typically diagnosed in women between 35 and 44 years old, but can occur at any adult age.

• Incidence & Mortality
  According to GLOBOCAN 2020 data, cervical cancer is the fourth most common cancer in women worldwide, with substantial incidence in low- and middle-income countries where screening programs are less available.

---

What Is Endometrial Cancer?

• Origin
  Endometrial cancer (also called uterine cancer) starts in the endometrium, the inner lining of the uterus.

• Main Cause
  Often linked to prolonged exposure to estrogen without enough progesterone, obesity, diabetes, and certain genetic factors.

• Age Group
  Most frequently diagnosed in women aged 55 to 65, especially after menopause.

• Incidence & Mortality
  In high-income countries, endometrial cancer is the most common gynecologic cancer. Its incidence has been rising, partly due to obesity and longer life spans.

---

Key Differences at a Glance

Feature	Cervical Cancer	Endometrial Cancer
Primary Site	Cervix (lower uterus)	Endometrium (uterine lining)
Main Risk Factor	High-risk HPV infection	Unopposed estrogen (e.g., obesity, HRT)
Typical Age	35–44 years	55–65 years
Screening Test	Pap smear, HPV DNA test	No routine screening; may use ultrasound
Most Common Symptom	Abnormal vaginal bleeding/discharge	Postmenopausal bleeding
Diagnosis	Colposcopy, biopsy	Endometrial biopsy, ultrasound
Treatment	Surgery, radiation, chemo, immunotherapy	Hysterectomy, radiation, chemo, hormones

---

Symptoms

Both cancers can cause vaginal bleeding, but the context differs:

• Cervical Cancer

  • Bleeding between periods or after intercourse
  • Unusual vaginal discharge (often watery, bloody, or foul-smelling)
  • Pelvic pain or pain during sex

• Endometrial Cancer

  • Postmenopausal bleeding (most common)
  • Bleeding or spotting before menopause
  • Pelvic pain or pressure (less common)
  • Unintended weight loss or fatigue (advanced cases)

If you notice any of these signs, consider doing a free, online symptom check for and speak to a doctor promptly about anything that could be serious.

---

Risk Factors

Cervical Cancer

• Persistent infection with high-risk HPV types
• Early onset of sexual activity or multiple sexual partners
• Smoking (weakens local immunity)
• Long-term use of oral contraceptives
• Immunosuppression (e.g., HIV infection)

Endometrial Cancer

• Obesity (excess fat cells produce estrogen)
• Diabetes and hypertension
• Use of estrogen-only hormone replacement therapy (HRT)
• Early menstruation or late menopause (longer estrogen exposure)
• Family history (e.g., Lynch syndrome)

---

Diagnosis

Cervical Cancer

1. Screening

   • Pap smear (cytology) every 3 years or
   • Pap + HPV co-testing every 5 years (ages 30–65)

2. Follow-up Tests

   • Colposcopy (magnified view of cervix)
   • Biopsy of suspicious areas
   • Imaging (MRI, CT, PET) for staging

3. Pathology

   • Immunohistochemical markers (e.g., p16 positive in HPV-related tumors) help distinguish cervical from endometrial adenocarcinomas (Trask et al., 2018).

Endometrial Cancer

1. Initial Evaluation

   • Transvaginal ultrasound (assess endometrial thickness)
   • Endometrial biopsy (office procedure)

2. Staging

   • Hysteroscopy (visual exam) with directed biopsy
   • Imaging (CT, MRI) to check for spread

3. Pathology

   • Hormone receptor status (ER/PR positive in many endometrioid tumors)
   • Molecular profiling guides targeted therapies

---

Treatment Approaches

Cervical Cancer

• Early Stage

  • Conization (removal of a cone-shaped piece of cervix)
  • Radical hysterectomy with lymph node evaluation

• Advanced Stage

  • Radiation therapy + concurrent chemotherapy
  • Targeted therapy or immunotherapy for recurrent/metastatic disease

Endometrial Cancer

• Early Stage

  • Total hysterectomy with removal of fallopian tubes and ovaries
  • Pelvic and para-aortic lymph node assessment

• Advanced Stage

  • Radiation (external beam, brachytherapy)
  • Chemotherapy (carboplatin/paclitaxel)
  • Hormonal therapy (progestins, aromatase inhibitors in select cases)

---

Prognosis

• Cervical Cancer
  Early detection via Pap smears and HPV testing has significantly improved 5-year survival rates (over 90% for localized disease).

• Endometrial Cancer
  Most are diagnosed early due to clear bleeding symptoms; localized disease has a 5-year survival rate above 80%.

Worldwide disparities in access to screening, diagnosis, and treatment account for differences in outcomes.

---

Prevention & Screening

• Cervical Cancer

  • HPV vaccination (recommended for preteens through mid-20s)
  • Regular Pap and HPV tests

• Endometrial Cancer

  • Maintain a healthy weight, manage diabetes and hypertension
  • Discuss risks/benefits of HRT with your doctor
  • No standard screening test for asymptomatic women

---

When to See a Doctor

• Any unusual vaginal bleeding or discharge
• Persistent pelvic pain
• Unexplained weight loss or fatigue
• Changes in bowel or bladder habits accompanied by bleeding

Early evaluation can catch problems sooner, improve outcomes, and reduce anxiety.

---

Disclaimer: This information is for educational purposes and does not replace professional medical advice. Always speak to a doctor if you have concerns about symptoms, diagnoses, or treatments that could be life-threatening or serious.