Normally, the first thing is to see your GP, who will ask you about your symptoms and will perform a vaginal exam to check for abnormalities. You may have blood and urine tests done.

You will likely be referred to a specialist for urgent care if you have:

  • Bleeding after menopause
  • A lump in your pelvis that your doctor can feel
  • Continuous vaginal flow between periods after a pelvic exam reveals nothing abnormal

Your specialist will ask you about your overall state of health and whether you have immediate family members with uterine or colon cancer. They will also examine you and perform an internal pelvic exam, and they may also do a cytology test.

Blood test

Blood samples may be taken to check on your overall state of health, the number of blood cells in your blood (complete blood count), and to see how your liver and kidneys are working.

Transvaginal ultrasound

Sound waves are used to create an image of the interior of the uterus, providing information on the thickness of the lining.

A small probe with a rounded end is inserted into the vagina. This may be a bit uncomfortable though shouldn't be painful. The test takes a few minutes. If it isn't possible to perform the test through the vagina, it may be done by passing a small device through the abdomen.

Biopsy

This involves taking a sample of cells or tissue from the lining of the uterus so that it can be examined under a microscope. If cancer cells are present, the type of uterine cancer can be identified.

Ambulatory hysteroscopy

A thin, flexible tube (hysteroscope) with a light on one end is inserted through the vagina and the cervix and into the uterus.

A speculum can be inserted in the vagina, injecting a small amount of anesthesia in the cervix to help it open up. Sometimes, women are recommended to take a painkiller an hour before the test.

The image of the interior of the uterus are shown on a screen. Sometimes, liquid or air is used in the hysteroscope to try to get a better image. A sample of tissue is taken of the mucosa of the uterus (biopsy).

CT (computed tomography)

A CT takes a series of x-rays, creating a 3-D image of the inside of the body. It takes from 5-15 minutes and is painless. A small amount of radiation is used, though it is very unlikely to cause you any harm. You will be asked to refrain from eating and drinking for at least an hour before the procedure.

You may be given a drink or an injection with a dye, which makes it possible to see certain areas more clearly. This may make you feel hot for a few minutes. It is important that you inform your health professionals if you are allergic to iodine or have asthma, as you may have a reaction to the injection.

MRI (magnetic resonance imaging)

This test uses magnetism to build a detailed image of one of the areas of your body. The scanner is a powerful magnet, which is why you will be asked to fill out and sign a checklist and provide your consent. As part of this consent form, you will be asked if you have any implants such as a pacemaker or surgical clips. You should also tell your doctor if you have ever worked with metals or in the metal industry.

Before the scan, you will be asked to remove all metal belongings, including jewelery. Sometimes, a contrast dye is given by injection in a vein of the arm to help the images come through more clearly.

You will have to remain very still during the test, which lasts about 30 minutes. The process is painless but can be somewhat uncomfortable, and some people experience a bit of claustrophobia. It is also quite loud, though you will be given earplugs or headphones.

PET/CT

This is a combination of computed tomography and positron emission tomography (PET). PET uses low doses of radiation to measure cell activity in different parts of the body. This test offers more detailed information on the part of the body being scanned.

You will not be able to eat for six hours before the test. A slightly radioactive substance is injected into a vein (normally the arm). This is followed by a wait of at least an hour before the examination, which takes between 30 and 90 minutes.

Chest x-ray

This uses x-rays to take an image of your chest so as to check on your lungs and heart.