Why Compare These Two Cancers?
You hear the words cervical and endometrial, and they might sound like they refer to the same thing. After all, both involve the uterus, right? But here’s the thing—they’re actually very different cancers that start in different places, behave differently, and need different treatments.
Understanding the difference isn’t just for doctors. If you’re someone with a uterus, or someone who loves someone with a uterus, this is information you deserve to know.
Where Each Cancer Begins
Let’s start with the basics: location.
- Cervical cancer starts in the cervix, which is the lower, narrow part of the uterus that connects to the vagina. Think of it as the doorway between the uterus and the outside world.
- Endometrial cancer, on the other hand, begins in the endometrium, which is the inner lining of the uterus. This lining thickens and sheds during your menstrual cycle.
So while both cancers are technically “gynaecological,” they start in completely different parts of the reproductive system. That matters a lot.
Causes and Risk Factors
The causes? Not the same either.
- Cervical cancer is mostly caused by a virus—the human papillomavirus (HPV). It’s incredibly common and usually harmless, but certain strains can lead to cancer over time. Smoking, having multiple sexual partners, and a weakened immune system increase the risk.
- Endometrial cancer isn’t linked to a virus. Instead, it’s often tied to hormonal imbalance, especially too much oestrogen without enough progesterone. That’s why it’s more common in women who are overweight, have polycystic ovary syndrome (PCOS), or take oestrogen-only hormone replacement therapy (HRT).
Genetics also play a role, especially with endometrial cancer. People with Lynch syndrome are at higher risk.
Early Warning Signs and Symptoms
One of the trickiest things about both cancers? The symptoms can be vague—or brushed off as “just part of being a woman.”
Here’s a breakdown:
- Cervical cancer:
- Bleeding after sex
- Unusual vaginal discharge
- Pelvic pain
- Bleeding between periods or after menopause
- Endometrial cancer:
- Abnormal bleeding, especially after menopause
- Heavy or prolonged periods
- Pelvic pain or pressure
What do they have in common? Bleeding when you’re not supposed to be bleeding. If that’s happening, don’t wait. It might not be serious, but it’s always worth checking.
Screening and Detection
Here’s where things really diverge.
- Cervical cancer has a routine screening test: the Pap smear (or Pap test). It detects abnormal cells in the cervix before they turn into cancer. There’s also the HPV test, which looks for the virus itself.If you’re between 25 and 65, regular screening can catch cervical cancer early—or even prevent it altogether.
- Endometrial cancer? Unfortunately, there’s no standard screening. It’s usually caught when symptoms appear, like postmenopausal bleeding. Some people at high risk (like those with Lynch syndrome) may be monitored more closely, but that’s not common practice for everyone.
So yes, cervical cancer gets the spotlight when it comes to prevention. Endometrial cancer often flies under the radar.
Diagnostic Process
Once symptoms show up, how are these cancers diagnosed?
- Cervical cancer:
- Begins with a Pap smear or HPV test
- Colposcopy (a magnified look at the cervix)
- Cervical biopsy
- Endometrial cancer:
- Usually starts with an ultrasound to check the thickness of the uterine lining
- Followed by an endometrial biopsy (a sample of the lining)
- Sometimes a hysteroscopy or D&C (dilation and curettage) is needed for clearer results
In both cases, biopsy confirms the diagnosis, but the route to get there differs.
Staging and Progression
Once cancer is confirmed, doctors stage it—which means figuring out how far it’s spread.
- Cervical cancer tends to spread locally first (to nearby tissue or lymph nodes), but can later move to lungs or liver.
- Endometrial cancer often stays in the uterus early on but can spread to the ovaries, pelvis, or beyond if not caught quickly.
Stages range from I (early) to IV (advanced) for both. The earlier it’s caught, the better the outcome.
Treatment Approaches
Treatment options overlap in some ways, but there are key differences.
- Cervical cancer:
- Early stages: surgery to remove the cervix or uterus
- Advanced stages: radiation, chemotherapy, and more recently, immunotherapy
- Fertility-sparing surgery may be an option for young patients with very early cancer
- Endometrial cancer:
- Main treatment is hysterectomy (removal of uterus and often ovaries)
- May also include radiation or chemotherapy
- Hormone therapy can help in some cases, especially if cancer is caught early and the patient wants to preserve fertility
The key difference? Endometrial cancer is usually surgical first, while cervical cancer treatment depends more on stage and may involve multiple therapies upfront.
Prognosis and Survival Rates
Good news: both cancers can be highly treatable, especially when found early.
- Cervical cancer:
- 5-year survival rate is about 66%, but that number jumps to over 90% for early-stage cases (ACS, 2023)
- Endometrial cancer:
- Generally has a better prognosis overall, with a 5-year survival rate of around 81%, especially if caught early (CDC, 2022)
The biggest factor? Stage at diagnosis. Which again highlights the importance of recognising those early signs.
Preventive Measures
Can these cancers be prevented? To some extent, yes.
- Cervical cancer:
- HPV vaccine (like Gardasil) protects against the virus that causes most cases
- Regular Pap smears and HPV testing
- Avoiding smoking and using condoms can also help
- Endometrial cancer:
- Maintain a healthy weight
- Manage diabetes or PCOS
- Discuss hormone therapy carefully if you’re using HRT
While screening saves lives in cervical cancer, lifestyle matters more in endometrial cancer prevention.
Living with and Beyond Cancer
Surviving cancer is just one part of the journey.
Many women face physical changes after treatment—early menopause, infertility, fatigue. There’s also the emotional weight: fear of recurrence, changes in body image, anxiety.
Support matters. Whether it’s through counselling, support groups, or just having someone to talk to, recovery isn’t just about the body—it’s about the whole person.
And remember: follow-up care is crucial. Even after successful treatment, regular check-ups help catch any recurrence early.
Final Thoughts: Knowing the Difference Can Save Lives
Cervical and endometrial cancers might seem similar, but they’re distinct in every way that matters: from cause and symptoms to diagnosis and treatment.
The takeaway?
- Know your body.
- Don’t ignore abnormal bleeding.
- Get regular screenings.
- Ask questions, seek help, and don’t be afraid to push for answers.
Because the earlier we act, the better the outcome.
References
- “Cervical Cancer: What You Should Know”, American Cancer Society, 2023. https://www.cancer.org/cancer/cervical-cancer.html
- “Uterine Cancer (Endometrial Cancer)”, Centers for Disease Control and Prevention, 2022. https://www.cdc.gov/cancer/uterine/
- “HPV and Cancer”, National Cancer Institute, 2021. https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer
- “Endometrial Cancer – Treatment Options”, Cancer Research UK, 2023. https://www.cancerresearchuk.org/about-cancer/womb-cancer/treatment
- “Cervical Cancer Screening Guidelines”, World Health Organization, 2022. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer