Follow-up after uterine cancer (cervix or endometrium): schedule and advice

Why is follow-up needed after uterine cancer?

Follow-up has three aims:

• to detect any recurrence early, most occurring in the first 2 to 3 years;
• to manage the side effects of surgery, radiotherapy, brachytherapy or chemotherapy;
• to support you as you return to everyday life: sexuality, work, relationships, mood, prevention of other cancers.

The programme is tailored to the type of cancer, its stage, its risk profile and the treatments received. It is set at the end of treatment, often after discussion at a multidisciplinary team meeting, and shared between the oncology team, your gynaecologist and your GP. For an overview, see our Gynaecological cancer care page.

Your active involvement matters: note your symptoms between appointments, bring a list of your medicines and feel free to ask all your questions, including about sex or work.

How often are check-ups needed after cervical or endometrial cancer?

For cervical cancer, European guidelines (ESGO/ESTRO/ESP 2023) suggest the schedule below. It is a guide; your team may adjust it.

For endometrial cancer, the 2025 update of the European guidelines does not set a common schedule: it recommends individualised follow-up based on prognostic factors (including the molecular profile of the tumour), the treatments received, their side effects, your other health conditions and your needs. It points out that follow-up is mainly for support and for picking up health problems, with no proven survival benefit.

Between appointments, do not wait for the scheduled date if you notice a new symptom (see below).

What tests are done during follow-up?

The key element is the consultation: questions about your symptoms, examination of the abdomen and lymph nodes, speculum examination, and vaginal and rectal examination. Other tests are targeted.

After cervical cancer

• After surgery or fertility-sparing treatment (cone biopsy, trachelectomy), an HPV test and/or cytology are useful to monitor the remaining cervix or vagina.
• After radiotherapy, cytology is hard to interpret because of radiation-related changes; it is not done routinely.
• Pelvic MRI or a PET-CT scan are ordered if there are symptoms or an abnormal finding on examination, and sometimes some time after chemoradiotherapy to assess the response.

After endometrial cancer

• A vaginal vault smear is not recommended routinely, nor are routine blood tests (French National Cancer Institute, INCa, guidelines).
• Imaging (chest, abdomen and pelvis CT, MRI, PET-CT) is not routine for low-risk forms; it may be scheduled for high-risk forms, or ordered because of a symptom.
• The CA 125 blood test is only useful in certain situations, notably if it was raised at diagnosis.

For women with Lynch syndrome, specific follow-up is arranged, in particular regular colonoscopy.

What are the side effects after treatment for uterine cancer?

Many women have few or no after-effects. Others have effects that can be treated or that ease over time. Always mention them at your appointment.

• Vaginal dryness and narrowing, especially after brachytherapy or radiotherapy: pain during sex, light bleeding on contact. Moisturisers and lubricants, local oestrogen when allowed, and vaginal dilators after radiotherapy help prevent them. See our article on vaginal dryness.
• Urinary problems after radical hysterectomy: difficulty emptying the bladder, urgency, leakage. Rehabilitation or urodynamic tests may be offered.
• Bowel problems after radiotherapy: diarrhoea, urgency, late rectal bleeding (radiation proctitis).
• Lymphoedema: swelling of one or both legs after lymph node removal, less common with the sentinel node technique. Early treatment with drainage and compression is important.
• Lymphocele: a pocket of lymph fluid in the pelvis after lymph node removal, often harmless.
• Rare complications: a fistula between the vagina and the bladder or rectum, narrowing of a ureter. Passing urine or stools through the vagina needs prompt medical attention.
• Fatigue, anxiety, fear of recurrence: common, they warrant support (psychologist, supportive care, patient associations).

Can I take HRT after uterine cancer and treatment-induced menopause?

Removal of the ovaries or pelvic radiotherapy brings on menopause, sometimes early, with hot flushes, poor sleep, vaginal dryness and, in the long term, a higher risk of osteoporosis and cardiovascular disease.

• After squamous cell cervical cancer, menopausal hormone therapy is not contraindicated and is often advised in cases of early menopause.
• After early-stage, low-risk endometrial cancer, hormone therapy may be considered case by case, after discussing the benefit-risk balance. It is, however, not advised for advanced forms or certain histological types.
• Non-hormonal alternatives exist for hot flushes (see our article on hot flushes).

How can I stay healthy after uterine cancer treatment?

• Regular physical activity and maintaining a healthy weight, particularly helpful after endometrial cancer, which is often linked to excess weight.
• Stopping smoking, especially after cervical cancer.
• Continuing screening for other cancers (breast, bowel) according to your age and history.
• Monitoring blood pressure, diabetes and cholesterol with your GP.
• Intimate life: sex can usually resume a few weeks after the end of treatment, with the team's agreement. A consultation with a sex therapist can help.

What about fertility?

After fertility-sparing treatment (cone biopsy, trachelectomy, or hormone treatment of early endometrial cancer), pregnancy is possible. It is planned with the team that follows you: waiting time after the end of treatment, prior checks, and adapted obstetric monitoring. After fertility-sparing treatment of the endometrium, it is often advised not to delay pregnancy plans too long, then to discuss hysterectomy once your family is complete.

When should I see a doctor before my next follow-up appointment?

• Vaginal or rectal bleeding, even slight.
• New or foul-smelling vaginal discharge, or urine or stools passing through the vagina.
• Persistent pain in the pelvis, back or legs.
• A swollen leg, persistent cough, unexplained weight loss, unusual fatigue.

If you have heavy bleeding with feeling faint, sudden breathlessness or severe calf pain, in France call 15 (or 112, or your local emergency number).

Follow-up at the practice: follow-up is carried out in liaison with the centre where you were treated; appointments can be booked on Doctolib or on 01 43 79 59 79.

Frequently asked questions

General information article: it does not replace a medical consultation. In an emergency, call 15 or 112 in France, or your local emergency number.