Know your body. Ask the questions.

It is rising while almost everything else falls.

For most cancers, decades of research have pushed death rates down. Uterine cancer is the exception. It is one of the only cancers in the United States where deaths are climbing, and the trend is expected to continue for decades. Incidence has held roughly steady in white women but has kept rising, year after year, in women of every other racial and ethnic group.

The single biggest driver is the rise in obesity, which raises the body's estrogen levels and, with it, the risk to the uterine lining. That is also why doctors are now seeing this disease in younger women than ever before. A cancer once thought of as a concern only after menopause is no longer staying in that lane.

A disease that is getting more common, more aggressive, and younger is exactly the wrong disease to be detecting late.

Not every woman faces the same odds.

Black women die of uterine cancer at nearly twice the rate of white women, and they are far more likely to be diagnosed at a late stage, when the disease is hardest to treat. The five-year survival gap, 63 percent for Black women against 84 percent for white women, is one of the largest racial gaps in all of cancer. Aggressive forms of the disease are rising fastest in Black women, too.

These gaps are not about biology alone. They are driven by later diagnosis, uneven access to expert care, and delays in getting the right treatment at the right time. Black women are also more likely to develop the more aggressive subtypes of the disease.⁴ That is precisely why equity is built into this foundation, not added as an afterthought. Earlier answers have to reach the women who are currently being failed the most.

What raises the odds.

Some women carry more risk than others, and knowing where you stand is the first step to acting earlier. The strongest driver is obesity: excess body fat raises estrogen that continually stimulates the uterine lining, and more than half of uterine cancers, around 57 percent, are attributable to it.⁵ Risk also rises with type 2 diabetes, never having given birth, an early first period or late menopause, taking estrogen without progesterone, the breast-cancer medication tamoxifen, and a family history of uterine, ovarian, or colorectal cancer, including Lynch syndrome.⁵

Today, we mostly wait for symptoms.

Here is the part most women do not realize: there is no routine screening test for uterine cancer. Nothing like the mammogram, nothing like the Pap smear. For a woman with no symptoms, the current system has essentially nothing to offer her in the way of early detection.

Instead, diagnosis usually begins only after a symptom appears, most often abnormal bleeding. About nine in ten uterine cancers are found because a woman bleeds and seeks help. That is the entire safety net: notice the bleeding, report it, get evaluated.

And even that net has holes. For years, the standard first step for postmenopausal bleeding was an ultrasound alone. But ultrasound by itself can miss cancer.

A system that waits for symptoms, and until this year was missing them even then, is not a screening plan. It is a gamble. We are working to change that.

Know these. Track them. Report them.

Abnormal bleeding is the hallmark sign, present in roughly nine of ten cases.¹ But what counts as "abnormal" looks different at different stages of life. Here is what to watch for.

• Any bleeding after menopauseEven a single episode of bleeding or spotting after menopause is never normal. Report it right away.
• Changes in your period before menopauseUnusually heavy bleeding, periods that last longer than your normal, or bleeding between periods.
• Spotting or irregular bleeding in younger womenWorth checking, especially alongside risk factors like obesity, PCOS, or family history.
• Abnormal vaginal dischargeAny change in amount, color, or texture, and any discharge after menopause.
• A persistent change in urinary habitsNew, ongoing changes that do not resolve on their own.
• Unexplained weight lossLosing weight without trying.
• Later-stage signsConstant pelvic or abdominal pain, feeling full quickly, or abdominal swelling. Do not wait for these to act.

A practical habit: keep a simple note on your phone. Track what is normal for you, and write down anything that changes. A clear record turns a vague worry into a specific conversation your doctor can act on.

The questions worth asking out loud.

You do not have to know the medicine. You just have to start the conversation. These are the sentences that move you from waiting to acting:

• "This bleeding is not normal for me. I want it evaluated for uterine cancer. What is the next step?"
• "Given my personal and family history, do I have risk factors for uterine cancer I should know about?"
• "Should I consider genetic testing for a hereditary syndrome such as Lynch syndrome?"
• "How do I tell normal menopausal changes from warning signs I should worry about?"
• "If we do an ultrasound, do I also need a tissue biopsy so nothing is missed?"
• "Are there screening or early-detection options that make sense for me, at my age or risk level?"
• "What would make you refer me to a gynecologic oncologist?"
• "Are there lifestyle changes that would lower my risk, like weight, activity, or diet?"
• "Could my hormone therapy or any medications I take affect my risk?"
• "If this continues or comes back, what should I do, and how soon?"