Ovarian & Endometrial Cancer

Causes & Risk Factors

Risk factors differ somewhat between ovarian and endometrial cancer, though both share some hereditary and hormonal influences:

•  Family history and inherited variants — a family history of ovarian, breast, or colorectal cancer, or a known BRCA1/BRCA2 or Lynch syndrome variant, increases risk of both cancers.

•  Hormonal and reproductive factors — nulliparity (never having given birth) and endometriosis are associated with increased ovarian cancer risk.

•  Unopposed estrogen exposure — obesity, certain hormone therapies, and tamoxifen use are associated with increased endometrial cancer risk.

•  Age — both cancers are more common with increasing age, particularly after menopause.

•  Lynch syndrome — associated with increased risk of both endometrial and ovarian cancer, alongside colorectal cancer risk.

Symptoms & When to Test

Both ovarian and endometrial cancer can present with subtle or nonspecific symptoms, which is part of why they can be identified at a later stage than some other cancers.

•  Ovarian cancer — persistent bloating, pelvic or abdominal pain, early satiety (feeling full quickly), and urinary urgency or frequency, particularly if new and persistent

•  Endometrial cancer — abnormal vaginal bleeding, including postmenopausal bleeding or irregular bleeding between periods, which is the most common and important warning symptom

•  Unexplained pelvic pain or pressure

•  Unexplained weight loss

When Should You Consider Testing?

Persistent bloating, pelvic pain, or early satiety lasting more than a few weeks warrants evaluation for possible ovarian cancer. Any postmenopausal bleeding, or abnormal bleeding between periods, should be evaluated promptly, as this is the key warning symptom for endometrial cancer.

Why Tests Are Combined

For ovarian cancer, histopathology establishes the diagnosis and tumor type, while BRCA1/BRCA2 and homologous recombination-related testing serve two purposes — identifying hereditary risk relevant to the patient and family, and determining eligibility for PARP inhibitor therapy, a targeted treatment option specifically effective in tumors with these genetic features.

For endometrial cancer, modern classification combines MMR IHC (relevant to Lynch syndrome and immunotherapy eligibility), p53 IHC (associated with more aggressive tumor behavior when abnormal), and POLE testing (associated with a favorable prognosis) — together these provide a molecular classification that refines the prognostic and treatment information beyond histopathology alone.

This molecular classification approach for endometrial cancer, in particular, reflects an important shift in how gynecological cancers are now understood — where molecular subtype often carries as much or more clinical significance than traditional histological grading alone.

Tests Available at NPL

Most tumor molecular tests, histopathology, IHC, and genetic tests do not require fasting. However, some blood-based investigations ordered alongside cancer testing may have specific preparation requirements. Please follow the instructions provided by your doctor or NPL.

Home Sample Collection

Ovarian and endometrial cancer diagnosis requires a tissue biopsy or surgical specimen, obtained by a specialist gynecologic oncologist or surgeon — this is not a home sample collection service.

Once your tissue sample is obtained, NPL arranges secure transport to our accredited laboratory for histopathology and molecular testing.

Germline BRCA1/BRCA2 testing (assessing inherited risk, as opposed to tumor-based testing) can, in some cases, be arranged via a standard blood draw — ask your care team whether NPL's home collection service applies to your specific germline testing request.

Reports are delivered securely to your treating gynecologic oncologist, and to you, within the timeframe specified for the tests ordered.

When to See a Doctor

•  Persistent bloating, pelvic pain, or early satiety lasting more than a few weeks

•  Any postmenopausal bleeding

•  Abnormal bleeding between periods

•  Unexplained pelvic pain or pressure

•  Family history of ovarian, endometrial, breast, or colorectal cancer, or known BRCA/Lynch syndrome variant in the family