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Health condition · Clinically reviewed

Gynaecological cancers, endometrial, ovarian, cervical, vulval and beyond.

A group of very different cancers with one thing in common - outcomes are transformed by specialist gynae-oncology care, modern molecular testing, and access to PARP inhibitors and immunotherapy.

Jump to treatment
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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Checked against NICE, BGCS, RCOG, ESGO and peer-reviewed sources you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK practice including PARP inhibitors, immunotherapy for endometrial and cervical disease, and specialist commissioned services.

Key facts

Gynaecological cancers at a glance.

A short orientation to the five main types, how they usually present, and what modern UK treatment looks like.

  • What it covers

    Cancers of the womb (endometrium), ovaries and fallopian tubes, cervix, vulva, vagina, and gestational trophoblastic disease.

  • Most common

    Endometrial cancer is now the commonest gynaecological cancer in the UK, mostly presenting with postmenopausal bleeding.

  • Most lethal

    Ovarian cancer often presents late with vague symptoms - bloating, early satiety, urinary and bowel change.

  • HPV-driven

    Cervical, most vulval and most vaginal cancers are HPV-related - screening and HPV vaccination are reducing incidence.

  • Genetics

    BRCA1, BRCA2 and HRD are checked in ovarian cancer; Lynch syndrome in endometrial. Findings guide treatment and family screening.

  • New drugs

    PARP inhibitors, checkpoint immunotherapy and antibody-drug conjugates have transformed outcomes across several subtypes.

Why this guide matters

Five cancers, one specialist pathway.

Endometrial, ovarian, cervical, vulval and vaginal cancers behave differently but share one truth - outcomes are best when care is centralised in a specialist gynae-oncology MDT.

  • Specialist commissioned care

    Cytoreductive ovarian surgery, radical hysterectomy and trophoblastic disease management belong in tertiary units - volume matters.

  • Molecular testing is standard

    BRCA1/2, HRD and mismatch repair status now direct treatment across ovarian and endometrial cancer, not just family screening.

  • New drugs, real gains

    PARP inhibitors, checkpoint immunotherapy and antibody-drug conjugates have added years for many patients over the last decade.

How the diagnosis is made

From first symptom to a specialist MDT plan.

The NICE NG12 pathway, imaging and biopsy steps most UK patients go through, in order.

  1. 01

    Assessing

    Symptom recognition and 2WW referral

    Postmenopausal bleeding, persistent bloating, pelvic pain or abnormal bleeding trigger the NICE NG12 suspected cancer pathway.

  2. 02

    Assessing

    Pelvic examination

    Speculum and bimanual examination looks for cervical, vulval and vaginal lesions and pelvic masses.

  3. 03

    Assessing

    Transvaginal ultrasound

    First-line imaging for endometrial thickness, ovarian masses and adnexal disease.

  4. 04

    Confirming

    Tumour markers and RMI

    CA-125, HE4, and the Risk of Malignancy Index help triage suspected ovarian cancer to specialist care.

  5. 05

    Confirming

    MRI and CT staging

    Pelvic MRI stages endometrial and cervical disease; CT chest, abdomen and pelvis maps ovarian spread.

  6. 06

    Confirming

    Tissue diagnosis

    Endometrial pipelle or hysteroscopic biopsy, cervical biopsy, vulval punch biopsy, or diagnostic laparoscopy for ovarian disease.

  7. 07

    Planning

    Specialist gynae-oncology MDT

    FIGO staging and treatment planning happen in a specialist commissioned centre with dedicated surgeons, oncologists and pathologists.

Typical timeline: 2WW referral to MDT plan within a few weeks in most UK centres.

Symptoms

What to look for.

Different cancers, overlapping symptoms. These are the patterns that should always prompt a medical review.

  • Postmenopausal bleeding

    Any bleeding after the menopause is endometrial cancer until proven otherwise - the most important single symptom.

  • Abnormal vaginal bleeding

    Intermenstrual, postcoital or unusually heavy bleeding can signal cervical or endometrial disease.

  • Persistent bloating and abdominal fullness

    Bloating on most days for three weeks or more, especially over 50, warrants CA-125 and pelvic imaging.

  • Pelvic or abdominal pain

    New, persistent pelvic pain or a palpable pelvic mass needs urgent gynaecology review.

  • Change in bowel or bladder habit

    New urinary frequency, urgency or altered bowel habit in an older woman can point to ovarian disease.

  • Vulval itch, lump or ulcer

    A non-healing vulval lesion, persistent itch or lichen sclerosus with a new lump needs biopsy.

  • Unintentional weight loss and fatigue

    Systemic symptoms alongside pelvic complaints raise suspicion of advanced disease.

  • Red flag - haematuria or bowel bleeding

    Blood in urine or stool with pelvic symptoms can reflect locally advanced gynaecological cancer.

Treatment

How gynaecological cancers are treated in the UK.

Surgery, radiotherapy and platinum-based chemotherapy remain foundational. Molecular testing, PARP inhibitors, immunotherapy and antibody-drug conjugates add powerful modern layers.

  • Specialist gynae-oncology surgery

    Hysterectomy with bilateral salpingo-oophorectomy, lymphadenectomy, omentectomy and peritoneal biopsies in a commissioned centre.

  • Laparoscopic and robotic surgery

    Minimal access surgery for early endometrial and some cervical cancers, with faster recovery. See our laparoscopic hysterectomy guide.

  • Fertility-sparing surgery

    Selected early endometrial, cervical and ovarian cancers can be treated with cone biopsy, trachelectomy or unilateral oophorectomy.

  • Platinum-based chemotherapy

    Carboplatin and paclitaxel remain the backbone for ovarian, high-risk endometrial and metastatic cervical disease.

  • Radiotherapy and brachytherapy

    External beam radiotherapy with brachytherapy boost is central to cervical cancer and adjuvant endometrial care.

  • PARP inhibitors

    Olaparib, niraparib and rucaparib are practice-changing maintenance for BRCA-mutated and HRD-positive ovarian cancer.

  • Immunotherapy

    Pembrolizumab and dostarlimab for dMMR endometrial cancer and PD-L1 positive cervical cancer - specialist commissioned.

  • Targeted and ADC therapies

    Bevacizumab, mirvetuximab soravtansine and tisotumab vedotin extend options in ovarian and cervical disease.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, specialist society standards and European consensus documents, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or gynae-oncology team knows your history and imaging and can tell you which parts apply to you. If in doubt, get seen.

  • NICE. Suspected cancer: recognition and referral (NG12).

  • British Gynaecological Cancer Society (BGCS). Guidelines for ovarian, endometrial, cervical and vulval cancer.

  • RCOG and BSGE. Guidance on hysteroscopy, laparoscopy and gynaecological cancer surgery.

  • ESGO/ESTRO/ESP. European guidelines for endometrial, cervical and ovarian cancer.

  • NHS England. Specialised commissioning for gestational trophoblastic disease (Charing Cross, Weston Park, Ninewells).

Red flags

When symptoms need urgent attention.

Situations where a two-week-wait referral or specialist review must not be delayed.

  • Postmenopausal bleeding

    Any bleeding after 12 months of amenorrhoea needs 2WW referral for transvaginal ultrasound and endometrial sampling.

  • Persistent bloating over 50

    Bloating on most days for at least three weeks, especially in women over 50, warrants urgent CA-125 and pelvic imaging.

  • Non-healing vulval lesion

    A vulval lump, ulcer or plaque that has not resolved in 4 to 6 weeks needs urgent biopsy under 2WW.

  • Abnormal cervical screening

    High-grade dyskaryosis or persistent high-risk HPV needs colposcopy and, if indicated, LLETZ or cone biopsy.

  • Rapidly rising hCG after pregnancy

    Persistent trophoblastic disease or choriocarcinoma - refer to a specialist commissioned centre.

  • Family history of BRCA or Lynch

    A strong family history of breast, ovarian, endometrial or colorectal cancer needs a clinical genetics referral.

  • Ascites or pleural effusion

    Unexplained fluid with pelvic symptoms is often advanced ovarian cancer - urgent imaging and specialist review.

  • Haematuria or rectal bleeding

    Blood in urine or stool with pelvic symptoms may reflect locally advanced disease infiltrating adjacent organs.

  • Suspected malignancy in pregnancy

    Any suspected gynaecological cancer during pregnancy needs a joint obstetric and oncology MDT in a commissioned centre.

Living with it

After treatment, a long horizon.

Follow-up, menopause management, genetic testing and psychological support are all part of good gynaecological cancer care.

A quiet reminder

You are still a whole person after a cancer diagnosis.

Sexual health, relationships, fertility and mental wellbeing all deserve honest conversations with your team.

  1. 01 Follow-up

    Structured surveillance

    Specialist clinic review, imaging and tumour markers on a set schedule for at least five years after primary treatment.

  2. 02 Menopause

    Managing surgical menopause

    Bilateral oophorectomy causes sudden menopause - discuss HRT safety, bone health and mood support with your team.

  3. 03 Genetics

    BRCA, HRD and Lynch testing

    Germline and somatic testing informs treatment and family screening - cascade testing is offered to relatives.

  4. 04 Support

    Charities and psychological care

    Eve Appeal, Ovacome, Target Ovarian Cancer, Jo's Cervical Cancer Trust and Macmillan offer information, peer support and counselling.

Frequently asked

Questions we hear from patients.

Straight answers on presentation, diagnosis, targeted therapy and specialist commissioned care.

  • What are the main gynaecological cancers?

    Cancers of the womb (endometrium), ovaries and fallopian tubes, cervix, vulva and vagina, plus gestational trophoblastic disease including choriocarcinoma. Rarer cancers include uterine sarcoma.

  • What is the most common gynaecological cancer in the UK?

    Endometrial (womb) cancer is now the most common, largely because it usually presents early with postmenopausal bleeding. Ovarian cancer is less common but tends to present later and is more lethal.

  • What symptoms should I take seriously?

    Postmenopausal bleeding, persistent abnormal bleeding, ongoing bloating, pelvic pain, a non-healing vulval lump, or a new change in bowel or bladder habit lasting more than three weeks. Under NICE NG12 these can trigger a two-week-wait referral.

  • How is ovarian cancer diagnosed?

    Blood tests such as CA-125 and HE4, transvaginal ultrasound, the Risk of Malignancy Index (RMI), CT and often diagnostic laparoscopy. Definitive staging is done by a specialist gynae-oncology MDT.

  • What are PARP inhibitors?

    Oral targeted drugs (olaparib, niraparib, rucaparib) that exploit DNA repair defects in BRCA-mutated and HRD-positive ovarian cancers. Used as maintenance after platinum chemotherapy, they have significantly extended progression-free survival.

  • Where is gestational trophoblastic disease treated?

    In the UK, molar pregnancy and choriocarcinoma are managed through nationally commissioned centres at Charing Cross Hospital (London), Weston Park Hospital (Sheffield) and Ninewells Hospital (Dundee) with hCG surveillance.

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