Staging and grading womb cancer

Knowing the stage of the cancer is important because it affects the decisions you and your doctor will make about treatment. Your doctor won’t know the exact stage of the cancer until after your operation to remove the cancer and when the results of all your tests are ready.

Womb cancer is divided into four main number stages, and some of these are sub-divided.

Staging Back to top

Stage 1

The cancer is contained in the womb. There are two stages:

Stage 1A

The cancer is only in the lining of the womb or has grown no more than halfway into the muscle.

Stage 1B

The cancer has grown more than halfway into the muscle wall.

Stage 2

The cancer has spread to the cervix.

Stage 3

The cancer has spread but is confined to the pelvis. There are three stages:

Stage 3A 

The cancer is affecting the outer covering of the womb and/or involves the ovaries and fallopian tubes.

Stage 3B 

The cancer has spread into the vagina and/or into the tissue between the womb and the side wall of the pelvis (parametrium).

Stage 3C

The cancer has spread to the pelvic lymph nodes and/or to the lymph nodes at the back of the tummy (abdomen).  

Stage 4

The cancer has spread to other organs in the body. There are two stages:

Stage 4A

The cancer has spread to the bowel and/or the bladder.

Stage 4B

The cancer has spread to the lungs, bones or the brain (called secondary cancers or metastases).

Other terms

Some other terms may be used to describe the cancer:

Early-stage womb cancer 

This usually refers to stages 1 and 2.

Locally advanced womb cancer

This usually refers to stage 3 and stage 4A womb cancers.

Advanced or secondary womb cancer 

This is usually stage 4B womb cancer.

If a cancer comes back after it was first treated, it’s called recurrent cancer.

Grading Back to top

Grading is about how the cancer cells look under the microscope compared with normal cells. The grade helps your doctor decide if you’ll need further treatment after surgery. 

Grade 1 (low-grade)

The cancer cells tend to grow slowly, look quite similar to normal cells (are ‘well differentiated’) and are less likely to spread than higher grades.

Grade 2 (moderate-grade)

The cells look more abnormal and are growing slightly quicker.

Grade 3 (high-grade)

The cancer cells tend to be growing more quickly, look very abnormal (are ‘poorly differentiated’) and are more likely to spread than low-grade cancers.