While many cancers, including lung and colon cancers, have been decreasing in the US, the opposite is true of uterine cancer.

New cases of this cancer (also called endometrial cancer because it starts in the endometrium, the lining of the uterus) are up 12% since 1999 and deaths are up by 21%!

What’s going on? These trends follow the rise in obesity among women in the US. Women who are overweight or obese are two to four times more likely to develop uterine cancer than women who are at a healthy weight. The connection is the female hormone estrogen, which stimulates this cancer and is overproduced in fat cells. In fact, about 40% of uterine cancer cases are linked to obesity.

Other uterine cancer risk factors include having diabetes and eating a diet high in animal fat (two factors also associated with being overweight or obese), being over age 50 and having a family history of uterine cancer. Black women are twice as likely to die from uterine cancer as women of other races. This may be due to a higher rate of obesity and being diagnosed at a later stage of the cancer than other women.

To lower your risk for uterine cancer, the Centers for Disease Control and Prevention suggests eating a healthy diet and being physically active in order to maintain a normal weight.

Because screening tests for uterine cancer are not done routinely, it’s important to know the warning signs, most commonly vaginal bleeding after sexual intercourse, between periods or after menopause. This is often the first and most important sign that can lead to an early diagnosis—90% of women with this cancer have abnormal vaginal bleeding, so don’t ignore it. Other signs include pain after sexual intercourse, lower-belly pain and pain after passing urine.

Note: The test called transvaginal ultrasound is available for screening women at high risk for uterine cancer. It is also used to help diagnose cancer in women who have symptoms.

Early diagnosis and treatment are the keys to survival. When treated at an early stage, survival rates after five years are 80% to 90%. Once this cancer has time to spread, the five-year survival rate drops to under 30%.