The commonest presenting symptom is post-menopausal bleeding. It is now clear that the use of endometrial biopsy alone is not sufficient to exclude endometrial cancer. Either ultrasound or hysteroscopy should also be used. The most important protective factor is use of the combined oral contraceptive pill. A protective effect appears after twelve months of use.
Parity is a protective factor.
As techniques are now available for performing endometrial ablation, it is likely that hysterectomy rates will decline. There is no prospect for introducing screening for asymptomatic women in the general population. The oral contraceptive pill is unlikely to be used as a form of chemoprevention. At present, in Scotland, no such guidelines exist. Therefore, surgical treatment for high risk cases is not always done by specialist gynaecological oncologists.