Uterine cancer is the most common cancer of the female reproductive system, with an estimated 68,270 new cases expected in the United States in 2026. That makes it the 9th most common cancer overall, ahead of leukemia and behind non-Hodgkin lymphoma. And the numbers are climbing: incidence has been rising steadily for over two decades.
Where Uterine Cancer Ranks
Among gynecologic cancers (those affecting the uterus, ovaries, cervix, vulva, and vagina), uterine cancer is the most frequently diagnosed by a wide margin. To put 68,270 annual cases in perspective, that’s roughly one-fifth the number of new breast cancer cases each year, but it still affects tens of thousands of people annually. It ranks 9th among all cancer types in estimated new diagnoses, just behind kidney cancer and non-Hodgkin lymphoma.
Rates Are Increasing
Uterine cancer is not holding steady. Between 1999 and 2015, incidence rose about 0.7% per year, adding up to a 12% total increase over that period. Mortality climbed even faster, rising 1.1% per year. Those averages mask sharper increases in specific populations. Incidence among American Indian and Alaska Native women rose 53% over the same period. Black women saw a 46% increase, Asian and Pacific Islander women 38%, and Hispanic women 32%. White women had the smallest rise at 9%.
Rising obesity rates are a major driver. Excess body fat increases levels of estrogen produced by fat tissue, which stimulates the uterine lining and raises cancer risk. For every 5-point increase in BMI, the risk of developing endometrial cancer rises by about 59%. Women with a BMI over 40 face more than six times the risk of dying from uterine cancer compared to women at a healthy weight.
Most Cases Are Endometrial Cancer
The term “uterine cancer” covers several different diseases, but the vast majority start in the lining of the uterus (the endometrium). These endometrial carcinomas account for roughly 96% of all uterine cancer diagnoses. The remaining cases are uterine sarcomas, which develop in the muscle or connective tissue of the uterine wall. Among sarcomas, leiomyosarcomas make up about 2% of all uterine cancers, endometrial stromal sarcomas about 1.1%, and adenosarcomas about 0.5%.
This distinction matters because the subtypes behave differently. Endometrial carcinomas tend to cause abnormal bleeding early, which leads to earlier diagnosis. Sarcomas are rarer but often more aggressive and harder to catch at an early stage.
Who Is Most Affected
Uterine cancer is primarily a postmenopausal disease. Most cases are diagnosed in women in their 50s and 60s, though it can occur earlier, particularly in women with obesity, polycystic ovary syndrome, or certain genetic conditions like Lynch syndrome.
Racial disparities in uterine cancer are striking and growing. Black women are twice as likely to die from uterine cancer compared to other racial and ethnic groups. This gap exists partly because Black women are more likely to be diagnosed with aggressive, non-endometrioid subtypes that carry a worse prognosis. Hispanic women are experiencing the fastest increase in mortality from these aggressive subtypes, with rates rising 6.7% annually between 2010 and 2017, followed by Black women at 3.5%, Asian women at 3.4%, and White women at 1.5%.
Why There Is No Routine Screening
Unlike cervical cancer (which has the Pap smear) or breast cancer (which has the mammogram), there is no standard screening test for uterine cancer in people without symptoms. Transvaginal ultrasound and endometrial biopsy have both been studied, but neither has been shown to reduce deaths from the disease when used as routine screening tools in the general population.
The good news is that uterine cancer tends to announce itself. About 85% of cases are caught at an early, localized stage because the most common symptom, abnormal vaginal bleeding, prompts people to seek care. For postmenopausal women, any vaginal bleeding is considered abnormal and warrants evaluation. For premenopausal women, unusually heavy periods or bleeding between periods can be warning signs.
Key Risk Factors
Obesity is the single largest modifiable risk factor. The relationship is dose-dependent: the higher your body weight, the greater the risk. A woman with a BMI of 30 to 35 has about 2.5 times the risk of dying from uterine cancer compared to a woman at a normal weight. At a BMI above 40, that risk jumps to more than six times higher.
Other factors that increase risk include:
- Estrogen exposure without progesterone: Taking estrogen-only hormone therapy after menopause, or having conditions that raise estrogen levels without the balancing effect of progesterone
- Never having been pregnant: Pregnancy temporarily shifts the hormonal balance in the uterus in a protective way
- Late menopause: A longer lifetime of menstrual cycles means more cumulative estrogen exposure to the uterine lining
- Lynch syndrome: This inherited genetic condition significantly raises the risk of several cancers, including uterine cancer
- Type 2 diabetes: Often linked to obesity, but also independently associated with higher risk
Because abnormal bleeding is such a reliable early signal and most cases are caught before the cancer spreads, uterine cancer generally has favorable outcomes when treated promptly. But the rising incidence, particularly among younger women and women of color, makes awareness of these risk factors increasingly important.