What is the most common presenting symptom of endometrial cancer?

• A. Postmenopausal uterine bleeding
• B. Pelvic pain
• C. Abnormal vaginal discharge
• D. Urinary frequency

Answer: (A)

The key point is recognizing that abnormal uterine bleeding in a postmenopausal woman is the most common presenting sign of endometrial cancer. After menopause, any vaginal bleeding is abnormal, so new postmenopausal bleeding prompts evaluation for endometrial pathology, including cancer. Pelvic pain, abnormal vaginal discharge, and urinary frequency can occur but are not the typical initial symptom for most patients; they may appear with advanced disease or other conditions and are less specific for endometrial cancer.