What Black Women Need to Know About Endometrial Cancer

Black women are more likely to be diagnosed with more aggressive endometrial cancer, to be diagnosed at a later stage, and to die from endometrial cancer. Learning more about why these disparities exist can help create more awareness about endometrial cancer in Black women.

Black Women Are More Likely to Get Aggressive Forms of Endometrial Cancer

Black Women Are Often Diagnosed at an Advanced Stage

Endometrial cancer is often curable when caught early, but for Black women, the condition is frequently diagnosed at an advanced stage, says Ritu Salani, MD, a board-certified gynecologic oncologist at UCLA Health in Los Angeles.

• Pelvic discomfort
• Unexplained weight loss
• A feeling of fullness in the pelvis
• Vaginal bleeding

Black Women Face Much Higher Death Rates From Endometrial Cancer

Another challenge is how endometrial cancer is diagnosed, which may be less reliable for Black women, says Dr. Salani. Healthcare providers typically use transvaginal ultrasound to measure the thickness of the uterine lining. If the lining is thickened but under 4 millimeters, it's usually considered low risk for endometrial cancer, and no further testing is needed, she says.

Being informed about endometrial cancer symptoms can be lifesaving for Black women. Unlike breast cancer or cervical cancer, there's no screening test for endometrial cancer. But knowing and recognizing its warning signs, seeking care right away when something doesn't feel right, and advocating for yourself are your best defenses.

Know the Signs of Endometrial Cancer

“It's very important for Black women to understand what is normal when it comes to their uterine health,” says Onyewuenyi. The most common sign of endometrial cancer is abnormal vaginal bleeding or any postmenopausal bleeding, says Salani.

A typical menstrual cycle lasts between 21 and 35 days, and you generally bleed for two to seven days, says Onyewuenyi. If your bleeding pattern is different from this range, or if you have heavy bleeding, that's considered abnormal. Heavy bleeding means changing your pad or tampon every hour for several hours, passing blood clots bigger than a quarter, or using more than seven pads or tampons in one day, she adds.

• Bleeding between periods
• Heavy or prolonged periods
• Any bleeding after menopause (no matter how light)
• Pelvic pain or pressure
• Thin white or clear vaginal discharge (even if there's no blood) if postmenopausal
• Pain with sex

“It's a good habit to keep track of your menstrual patterns in a diary or electronic device,” says Onyewuenyi. And contact your healthcare provider as soon as you notice changes in your bleeding or new symptoms.

Know the Risk Factors

• Being older than age 50
• Being overweight
• A family history of endometrial cancer
• Starting your period early or experiencing menopause late
• Never having been pregnant
• A personal history of ovarian cancer
• Having polycystic ovarian syndrome
• Certain hormone therapies, such as estrogen replacement therapy without progesterone
• Certain genetic conditions, like Lynch syndrome or hereditary nonpolyposis colorectal cancer
• Exposure to chemical hair straighteners (relaxers) in postmenopausal women

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And know your family history. “Ask your family questions about cancer,” says Roberts. This can help your healthcare providers understand if you have a predisposition to genetic conditions and need extra testing or genetic screening, she says.

Practice a Healthy Lifestyle

• Maintaining a healthy weight
• Eating a balanced, nutritious diet
• Staying active with regular exercise
• Managing conditions like diabetes or high blood pressure

Roberts encourages Black women to take these steps, not just to reduce the risk of developing endometrial cancer but for overall well-being.

Report symptoms to your healthcare provider as soon as they appear, says Salani. Don't wait and don't hesitate to ask questions. It's always okay to bring up concerns and ask to be checked for endometrial cancer. Doing so can lead to sooner evaluation, earlier diagnosis, and better outcomes.

Advocate for Yourself

It may be intimidating, or you may feel uneasy speaking up about your care. But advocating for yourself can lead to more open conversations and better care. Here are some steps you can take if you feel unheard or dismissed by your healthcare providers:

• Ask questions. Onyewuenyi says that patient-centered care should include a clear conversation about risks, benefits, and options. If this is not provided, ask for it. Don't hesitate to ask, “Can you explain that again?” or “What are the alternatives?”
• Be assertive. If you feel brushed off or have more questions, Onyewuenyi suggests using words like “concerned,” “uncomfortable,” or “unsafe” to describe your feelings. These phrases can help providers pause, listen, and take your concerns seriously. Make sure your healthcare provider makes you feel heard.
• Talk about endometrial cancer directly. Ask specifically about endometrial cancer or uterine cancer, advises Salani. This puts the condition on your provider's radar and can lead to more thorough evaluation, including biopsy if needed, even when an ultrasound comes back negative.
• Know your fibroid history. Roberts notes that fibroids can make testing more difficult and lead to delayed or inaccurate diagnoses. If you have fibroids or aren't sure if you do, ask your healthcare provider about alternative testing methods.

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• Keep records. Keep detailed notes about your symptoms, when they occur, and what your healthcare providers tell you. Request copies of your medical records and document your interactions with providers. This is important in case you switch providers at some point, but also because you may want to reflect over this information later — there can be a lot of information to take in at once.
• Get a second opinion. You have the right to seek another medical opinion at any time, whether you want to understand all your treatment options or something doesn't feel right with your current care. Getting a second and sometimes third opinion can help you feel more confident in your decisions, but keep in mind that for practical purposes, you may want to choose a facility where you'll be able to transfer all of your care. Your insurance company can help you find covered providers for additional opinions. Organizations like Endometrial Cancer Action Network for African Americans (ECANA) also offer support and resources.
• Bring someone with you to appointments. A trusted friend or family member can help you ask questions, take notes, and feel supported during medical appointments.
• Ask about clinical trials. Clinical trials can offer access to new treatments and help make care and screening more relevant to Black women.

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   ECANA and other advocacy groups often share trial opportunities, especially those that focus on improving care for Black women.

Several organizations offer support and resources to Black women diagnosed with cancer through education, community, and advocacy.

ECANA

ECANA creates space for Black women with endometrial cancer to learn, share, and advocate for better care and outcomes.

Resilient Sisterhood Project

This organization educates and empowers women of African descent about reproductive health conditions that are rarely discussed.

Share Cancer Support

It provides support groups and educational resources for women affected by breast and gynecologic cancers, including endometrial cancer.

• Black women are about twice as likely to die from endometrial cancer, compared with white women, and are often diagnosed at a more advanced stage and with more aggressive forms of the disease.
• These disparities are partly due to systemic racism, delays in diagnosis and treatment, and challenges in getting care.
• There's no screening test for endometrial cancer. Knowing the warning signs, like abnormal vaginal bleeding after menopause, and getting medical help promptly can help catch issues early.
• If you feel unheard or dismissed, it's okay to speak up, ask questions, and get a second opinion to make sure your concerns are taken seriously.