Endometrial cancer, commonly referred to as uterine cancer, is a growing health concern in the United States, especially among postmenopausal individuals. The disease is one of the most prevalent gynecologic cancers nationwide, with approximately 69,000 new cases reported in 2025 and 13,000 deaths. Incidence and mortality rates have been increasing by roughly 1% annually since the mid-2000s, with the rise particularly notable among Black patients. A hallmark symptom of endometrial cancer is unexpected vaginal bleeding, often occurring after menopause. The disease is frequently aggressive and often diagnosed at an advanced stage, contributing to its lethality.
Recent advances in understanding the molecular biology of endometrial cancer have led to more targeted treatment options. In particular, research has focused on tumors characterized by mismatch repair deficiency (dMMR), a molecular marker present in about 25% of endometrial cancer cases. Three pivotal clinical trials have demonstrated that combining immune checkpoint inhibitors—a form of immunotherapy—with chemotherapy can more than double cure rates among patients with dMMR tumors, particularly in cases of advanced or recurring cancer. This marks a significant breakthrough, offering new hope for patients previously considered difficult to treat.
Reflecting these developments, the National Comprehensive Cancer Network (NCCN) updated its Guidelines® for Uterine Cancer to recommend immunotherapy alongside chemotherapy as a first-line treatment for advanced or recurrent dMMR endometrial cancer. While immunotherapy can have serious side effects, these are infrequent and, for many patients, the treatment may be both more effective and better tolerated than previous options.
The NCCN Guidelines® also now advocate for multigene panel testing for all newly diagnosed endometrial cancer patients. This genetic testing helps tailor treatment to an individual’s tumor profile and can identify an increased risk of other cancers, benefiting not only the patient but potentially their family members as well. Health care providers and patients are encouraged to ensure that genetic testing meets the most current guideline standards.
Patient education remains a critical element in improving outcomes. The NCCN provides accessible guidelines for patients and caregivers, with recent updates available in English and Spanish that cover topics such as genetic testing and managing immunotherapy side effects. Additionally, organizations such as the Society of Gynecologic Oncology and the International Gynecologic Cancer Society offer reliable resources on endometrial cancer. Patients are advised to consult their health care providers when evaluating new information to make informed decisions about their care.