Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

• Age and medical condition
• The type of cancer
• Severity of symptoms
• Previous test results

As with all types of cancer, early detection and treatment is important. In addition to a physical examination, the following tests may be used to diagnose uterine cancer:

Pelvic examination. The doctor feels the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to check for any unusual changes. A Pap test, usually done with a pelvic examination, neither finds nor diagnoses uterine cancer.

Transvaginal ultrasound. In this procedure, an ultrasound wand is inserted in the vagina and aimed at the uterus. An ultrasound uses sound waves to produce images of the uterus, including healthy tissues, cysts, and tumors. If the endometrium looks too thick, the doctor may decide to perform a biopsy.

Endometrial biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease). An endometrial biopsy is a procedure performed in the doctor's office, where the doctor removes a small sample of tissue with a very thin tube. The tube is inserted into the uterus through the cervix, and the tissue is removed with suction. This process takes about one minute. Afterward, the woman may have cramps and vaginal bleeding. These symptoms will go away and can be reduced by taking a nonsteroidal anti-inflammatory drug under a doctor's direction.

Dilation & curettage (D&C). A D&C is a procedure to remove tissue samples from the uterus. A woman is given anesthesia during the procedure.

Once endometrial tissue has been removed either during a biopsy or D&C, the sample is checked for cancer cells, endometrial hyperplasia, and other conditions.

X-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help doctors determine if the cancer has spread to the lungs.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines those images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a vein to provide better detail.