Uterine Cancer Ultrasound: Information & Get a Scan

Key takeaways:

• Uterine cancer happens when cells in the womb grow abnormally, often in the lining.

• Unusual bleeding is the most common early symptom.

• Ultrasound, especially transvaginal, is a safe first step to spot changes.

• A thicker or irregular womb lining on a scan may need further tests.

• Early diagnosis greatly improves treatment success and outcomes.

If you’ve noticed unusual bleeding, heavier periods, or pelvic pain, it’s natural to be worried. These changes are often the first signs that something may be wrong with your womb, and getting checked early can make a real difference. Uterine cancer, also called womb cancer, is one condition doctors look for when these symptoms appear, and understanding what to expect from tests like an ultrasound can help you feel more prepared and reassured.

What is Uterine Cancer?

Uterine cancer happens when cells in the womb grow abnormally to form a tumour. The uterus is the pear-shaped organ in your pelvis where a baby grows during pregnancy.

The most common type is endometrial cancer, which starts in the inner lining of the womb (the endometrium). This accounts for around 95% of cases, with around 8,000 new cases diagnosed in the UK every year. The less common type, accounting for 3-5% of cases, is uterine sarcoma, a rare and more aggressive cancer that usually develops in the muscle wall of the womb.

Uterine cancer is one of the most common gynaecological cancers, especially in women after the menopause, but it can develop at any age. Early diagnosis is important, as many cases can be treated successfully when found early.

What Are the Symptoms of Uterine Cancer?

If you have uterine cancer, the first thing you may notice is a change in your usual bleeding pattern. But there are other symptoms too. The main ones to look out for include:

• Unusual bleeding – this is the most common symptom. It might mean bleeding after the menopause, bleeding between periods, or much heavier periods than usual.

• Pelvic pain or pressure – a feeling of pain, heaviness, or pressure in your lower tummy or pelvis.

• Changes in vaginal discharge – discharge that is watery, bloody, or smelly.

• Bladder problems – such as pain or difficulty when passing urine.

• Pain during sex – some people notice new pain or discomfort during sex.

• Unexplained weight loss – losing weight without trying can sometimes happen if cancer affects your appetite, energy levels, or the way your body processes food.

• Abdominal pain – ongoing pain, cramping, or bloating in your tummy area that doesn’t go away.

• Changes to your bowel habits – such as constipation, diarrhoea, or needing to open your bowels more or less often than usual.

These symptoms don’t always mean you have uterine cancer, as other conditions can cause them. But it’s really important to get checked by your doctor if you notice anything unusual, especially any bleeding after the menopause.

Can an Ultrasound Detect Uterine Cancer?

An ultrasound, especially a transvaginal ultrasound (TVUS), is often the first test doctors use when they’re checking for uterine cancer. This scan can’t always give a definite diagnosis on its own, but it’s a really useful starting point.

TVUS works by measuring the thickness of the lining of your womb (endometrium). A thin lining (4mm or less) usually means there’s a very low chance of cancer, which can be reassuring. If the lining looks thicker, your doctor may recommend further tests, such as a biopsy (taking a small tissue sample for testing) or a hysteroscopy (using a tiny camera to look inside the womb), to check things more closely.

How Accurate is It?

It’s worth knowing that while ultrasound can help spot unusual growths in the uterus, it has its limits. Things like fibroids, the shape of your womb, or variations in how the images appear can sometimes make it harder to get clear results. The experience of the sonographer (the person carrying out the scan) can also make a difference.

That’s why your doctor may recommend a combination of tests, and sometimes an MRI, to get the clearest picture before making a diagnosis. So while ultrasound is an important first step, it’s usually just one part of the process of finding out what’s causing your symptoms.

Types of Ultrasound For Uterine Cancer

There are several types of ultrasound, each with its own benefits:

Transvaginal Ultrasound

This is usually the first scan your doctor will suggest. It involves having a small probe called a transducer inserted into your vagina to get a closer look at your womb. TVUS can measure how thick the endometrial lining is, which can be an important sign of problems. It gives a clear picture for many patients, and it’s especially useful for spotting changes in the endometrium early on.

Transabdominal Ultrasound

This scan looks at your womb through the lower tummy. While it’s less detailed than TVUS, particularly if you have a higher body weight, it can be useful for checking the overall size and position of the womb. 

Doppler Ultrasound

Doppler scans can measure blood flow in the womb and its arteries. This can sometimes provide extra clues about abnormal growths such as tumours or rare complications like uterine arteriovenous malformations, where there’s an abnormal connection between the arteries and veins in the womb.

3D Ultrasound

This can create a more detailed view of your womb’s shape and structure, and it’s useful in certain cases. However, it’s not considered to be any more useful than TVUS.

Contrast-Enhanced Ultrasound

This technique uses a special dye to highlight blood flow in tissues and may help to show how a tumour is growing or developing blood vessels.

How Does an Ultrasound Detect Uterine Cancer?

Ultrasound is a safe scan that uses sound waves to create pictures of your womb. These waves bounce back to the transducer in echoes, which a nearby computer converts to live images that your doctor can look at on a screen. Whether you have a transvaginal or abdominal ultrasound, the principles of how it works remain the same. 

How is Uterine Cancer Diagnosed?

When a doctor checks for uterine cancer, they’ll start by taking your medical history in detail. This will include asking you about unusual bleeding, pelvic pain or other symptoms, as well as assessing risk factors, such as obesity. Diabetes, high blood pressure, a history of abnormal womb lining or certain medications you’re taking. 

Next, they’ll ask permission to perform a pelvic examination. They’ll gently check the size, shape and movement of your womb and feel around for any lumps or abnormalities.

A transvaginal ultrasound is usually the first scan your doctor will offer. If the lining of the womb is 3mm or less, the risk of cancer is very low. If it’s thicker, your doctor will suggest more tests, including an endometrial biopsy, which takes a small sample of tissue from the womb lining to look for abnormal cells, called a pathology analysis. 

If the biopsy isn’t conclusive, your doctor may also suggest a hysteroscopy, which allows a specialist to look directly at samples of tissue inside your womb with a tiny camera and light, as well as remove a sample for further testing. A hysteroscopy usually involves a general anaesthetic and a few hours in hospital to recover. The results of the biopsy should confirm whether cancer is present.

As well as blood tests to look for markers that might suggest uterine cancer, your doctor may arrange for further scans to see if the cancer has spread to other parts of the body. These may include a computerised tomography (CT) scan, a magnetic resonance imaging (MRI) scan and a positron emission tomography (PET) scan.

What Are the Stages and Grades of Uterine Cancer?

Stages of uterine cancer describe how far the cancer has spread, while grades describe how abnormal the cancer cells look under a microscope.

Stage I means the cancer is confined to the womb, while Stage II means it has reached the cervix, but not yet spread beyond the womb. Stage III is considered advanced-stage cancer and means nearby areas, such as the vagina, ovaries or lymph nodes, are affected, and Stage IV means it has spread to distant parts of the body, such as the bladder or rectum.

Grade 1 is considered low-grade, as it means the cells resemble normal cells of the womb lining. Grade 2 means they are starting to look different. Grade 3 describes cells that are significantly abnormal and spreading aggressively.

Could My Symptoms Be a Sign of Something Else? (Differential Diagnosis)

When assessing your symptoms, your doctor will consider a range of other possibilities other than cancer:

• Abnormal vaginal bleeding: Could be caused by hormone changes, medications like tamoxifen, or ovulation problems.
  
  

• Pregnancy-related issues: Ectopic pregnancy or rare gestational conditions may cause bleeding.
  
  

• Hormonal imbalances: Conditions like polycystic ovary syndrome (PCOS), thyroid problems, adrenal disorders, or pituitary tumours can affect bleeding patterns. Signs like excess hair growth, hair loss, or other body changes may be a sign of hormone issues.
  
  

• Pelvic masses: Growths or cysts on the ovaries, fallopian tubes, or ligaments; fluid-filled structures like hydrosalpinx; scar tissue from surgery; or tumours from nearby organs (bladder, bowel, kidneys) may all appear as pelvic masses.
  
  

• Other cancers: Sometimes pelvic masses are caused by tumours spreading from other areas of the body.
  
  

Taking all these possibilities into account helps your doctor decide which tests to do next.

What Are the Causes of Uterine Cancer?

A mix of hormonal, metabolic, genetic, and environmental factors can all contribute to developing uterine cancer. 

Hormonal imbalances, such as having too much oestrogen or too little progesterone, can increase your risk, especially if you are obese, have polycystic ovary syndrome (PCOS), or insulin resistance. According to Macmillan, one in three womb cancers is linked to obesity. Certain medications, like hormone replacement therapy or tamoxifen, can also expose the womb to too much oestrogen and raise your risk of developing cancer.

Genetics matter too. Mutations in genes like BRCA1/2 or a family history of womb or hormone-related cancers can increase your risk. 

Exposure to radiation, particularly during puberty, is another factor. Other contributors include endometrial hyperplasia, uterine fibroids, smoking, and simply getting older.

Prognosis and Treatment

Generally, the earlier uterine cancer is found, the better the outlook. Most early-stage endometrial cancers have a good prognosis with high survival rates. If the cancer has spread to other parts of the body, the outlook is less optimistic, and there is a higher chance it may come back or continue to grow after treatment.

Treatment depends on the type and stage of your cancer, as well as your overall health. Often, your doctor will offer a combination of treatments to give you the very best chance of recovery.

• Surgery is usually the first step, especially if the cancer is found early. This often means removing the womb and cervix, and in many cases, both ovaries and fallopian tubes. 

• Radiation therapy uses high-energy beams to target cancer cells. It’s often used after surgery to reduce the chance of the cancer coming back, but in some cases it may be the main treatment if surgery isn’t suitable. 

• Chemotherapy uses drugs to kill cancer cells and may be recommended for more aggressive cancers, if the cancer has spread, or if it comes back after surgery or radiation. 

• Chemoradiation combines chemotherapy and radiation, often for higher-risk cancers, to make treatment more effective. 

• Hormone therapy can be used for cancers that depend on hormones to grow. It may involve tablets or an intrauterine device (IUD) that releases progesterone. 

• Immunotherapy works by helping your immune system fight the cancer, and targeted therapy attacks specific features of cancer cells. These treatments are usually for cancers that have spread or aren’t responding to other treatments. 

Why is an Ultrasound a Good Option?

Ultrasound is a quick, safe, and painless way to get a look inside your womb without using radiation. A transvaginal scan can check the thickness of the womb lining, helping spot anything unusual early. While it can’t give a full diagnosis, it’s a reassuring and useful first step if you notice changes like unusual bleeding or pelvic discomfort.

Where Can I Find an Ultrasound for Uterine Cancer?

Book a private ultrasound scan for cancer today to get a faster diagnosis—no GP referral needed. You can choose from the UK’s largest network of scanning locations with options near you and get a dedicated clinical team to handle all the paperwork for you. If you’re not sure whether an ultrasound is the right scan for your symptoms, our expert clinicians are on hand to talk you through your options in a one-to-one consultation. 

FAQs

What Does Uterine Cancer Look Like on Ultrasound?

It often appears as a thickened or irregular womb lining, sometimes with lumps or abnormal blood flow.

How Long Does a Uterine Ultrasound Take?

Usually 15–30 minutes, depending on the type of scan.

Can Uterine Cancer Be Missed on Ultrasound?

Yes, especially if the lining changes are subtle or other conditions like fibroids are present.

Can a Pelvic Ultrasound Detect Uterine Cancer?

Yes, it can spot abnormal lining or growths, but further tests are usually needed for a definite diagnosis.

Sources: 

Can Uterine Cancer Be Seen on an Ultrasound? (2023). https://www.healthline.com/health/cancer/uterine-cancer-on-ultrasound

Kyriazoglou, A., et al. (2018). Management of uterine sarcomas and prognostic indicators: real-world data from a single-institution. https://link.springer.com/content/pdf/10.1186/s12885-018-5156-1.pdf

Cancer of the uterus. (2023). https://www.cancervic.org.au/cancer-information/types-of-cancer/uterine_cancer/uterine-cancer-overview.html

Gynaecological cancers: recognition and referral. (2025). https://cks.nice.org.uk/topics/gynaecological-cancers-recognition-referral/

Malignant disease of the uterus. (N.D.) https://elearning.rcog.org.uk/product?catalog=co_maligdisuterus

Causes and risk factors of womb cancer. (2021). https://www.macmillan.org.uk/cancer-information-and-support/womb-cancer/womb-cancer-causes