The third ECAP report explores womb cancer diagnosis and care pathways in England
What is the Endometrial Cancer Audit Pilot?
The Endometrial Cancer Audit Pilot (ECAP) is a research project looking at womb (endometrial) cancer care, treatment, and survival across the NHS in England*. The British Gynaecological Cancer Society, British Association of Gynaecological Pathologists, 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 ECAP looked at 23,484 women diagnosed between 2017 and 2019.
The first Baseline Report gave an overview of womb cancer in England for the first time. Diagnoses have risen by 41% since 2001, likely linked to the increasing number of adults living with obesity.
The second Treatment Report showed how the treatments women receive can vary by age, health, background, cancer stage, and where you live.
This is a summary of the third ECAP report (May 2026), which looks at three key parts of the care pathway: how people get a diagnosis, tumour genomic testing, and access to newer immunotherapies.
What the Third Report found:
Diagnosis of womb cancer is usually through an urgent GP referral
Most women (62%) were diagnosed after visiting their GP, who referred them for further tests under the urgent suspected cancer referral pathway (previously called the “two-week wait”). This is a fast-track system to rule out or diagnose cancer.
Less commonly, 7% of women were diagnosed following an emergency admission (such as A&E). These women were more likely to have cancer at a later stage. Emergency diagnoses were also more likely among older women, those living in more deprived areas, and women with other health conditions. This also differed between ethnic groups, with the highest emergency presentation rates seen in Black women.
This is why raising awareness is so important to us at Peaches: understanding when and how womb cancer is diagnosed helps us support people to recognise symptoms early and seek help as soon as possible, which can save lives.
More tumour testing is being carried out
The report shows a strong increase in tumour genomic testing in recent years. By 2023, around 8 in 10 women had at least one test recorded.
Molecular testing allows care to be more personalised, helping ensure patients receive treatment that is better matched to their specific cancer.
The increase follows national efforts to expand this kind of testing, including work led by founding Trustees of Peaches Womb Cancer Trust, many of whom are also active cancer researchers. Some of this rise may also be due to better recording of information, not just changes in care. This is a positive step forwards.
Gradual increase in use of immunotherapy
Immunotherapy is a newer type of treatment, and overall use is still relatively low in womb cancer. Between 2017 and 2023, 2.5% of people had a record of receiving immunotherapy, although use has increased over time from 1.1% in 2017 to 3.5% in 2023. Differences in use were mainly linked to individual cases, rather than where someone lives.
At Peaches, we know how important it is to see new treatment options developing, especially for those with more advanced or recurrent womb cancer.
Why the ECAP matters:
The ECAP brings together real-world data to help us better understand how womb cancer is diagnosed, treated and recorded across England. It highlights where care is working well, and where there may be unfair differences that need further attention.
Findings from all three reports help build a clearer picture of people’s experiences across the care pathway, based on age, location, ethnic group and health through to treatment options, outcomes for different cancer stages and newer therapies.
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.
At Peaches, we believe this kind of evidence is vital. It helps shine a light on where services can improve, so that everyone affected by womb cancer can receive fairer, more consistent care and better support in the future.
Download the Third ECAP Report to read moreExplore more from the ECAP project:
- Read our summary of the Baseline Report (April 2025)
- Read our summary of the Treatment Report (January 2026)
- Access the full reports on the NDRS (National Disease Registration Service) website
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.
