New findings reveal how treatment for womb cancer differs across England.
What is the Endometrial Cancer Audit Pilot?
The Endometrial Cancer Audit Pilot (ECAP) is a research project looking at endometrial* cancer care, treatment, and survival across the NHS in England. The British Gynaecological Cancer Society, The Eve Appeal and Peaches Womb Cancer Trust are jointly funding this important project.
*Womb cancer is also known as endometrial or uterine cancer.
The Baseline Report (April 2025) gave an overview of endometrial cancer in England for the very first time.
Diagnoses have risen by 41% since 2001, likely linked to the increasing number of adults living with obesity. – ECAP Baseline Report
The ECAP looks at 23,484 women diagnosed between 2017 and 2019. During this three-year period, most women were diagnosed at stage 1, when womb cancer is usually very treatable.
Now, a second report, the Treatment Report, has been published (January 2026), showing how the treatments women receive can differ across the country.
What the Treatment Report looked at:
The report focuses on women diagnosed with endometrial cancer and the main treatments they received in England between 2017 and 2019: surgery (hysterectomy), chemotherapy and radiotherapy. It also looked for hormone (endocrine) therapy and lymph node assessments, and how well these are being recorded in NHS data.
What the report found:
Treatment can vary by age, health, background, cancer stage, and where you live
Age and health matter: Women in the middle age groups had the highest use of surgery, chemotherapy, and radiotherapy, while the youngest and oldest women had the lowest use of these treatments. Women without other health conditions were also more likely to receive treatment.
Background affects care: Treatment also varied for women experiencing social and economic hardship, and from different ethnic groups. This is important and suggests there may be extra barriers to getting treatment, beyond medical reasons.
Cancer stage makes a difference: The treatments women received often depended on how advanced their endometrial cancer was at diagnosis:
- Surgery was more common for patients diagnosed at stage 1–3A.
- Chemotherapy was used more often for patients diagnosed at later stages.
- Radiotherapy was mainly given to patients diagnosed at stage 2 or 3.
Variations by location: Some regions had lower-than-expected rates of treatment, especially for surgery and chemotherapy. Women who were diagnosed in hospitals with specialist gynaecological cancer centres were more likely to receive treatment.
Treatments aren’t always the same: Women received treatment in different ways, too. This included the type of hysterectomy, whether chemotherapy was given before or after surgery, the type of radiotherapy used, and combinations of treatments.
Data and record-keeping: The report found that NHS data isn’t always complete. Information on hormone therapy and lymph node assessments was limited, but more recent patient records suggest that recording is improving over time.
Why this report matters:
Looking at real-world treatment helps us spot patterns and unfair differences in care. This is an important step toward a national audit of endometrial cancer, following the successful model of the Ovarian Cancer Audit, and could potentially be expanded to include similar data from all four UK nations.
The ECAP reports help us understand where treatment is delivered consistently and where experiences of care differ, so that treatment and outcomes can improve for all women and people with womb cancer.
Download the ECAP Treatment Report to read moreFuture ECAP reports from this two-year project will look at genetic testing, how women with endometrial cancer are diagnosed, use of immunotherapy, and other insights, including information about place of death, to help improve care and support.
Acknowledgement
This work uses data that has been provided by patients and collected by the NHS as part of their care and support. The data are collated, maintained and quality assured by the National Disease Registration Service, which is part of NHS England.
