Diagnosis of Endometrial Cancer Endometrial biopsy The following suggest endometrial cancer: Postmenopausal bleeding Abnormal bleeding in premenopausal women (intermenstrual bleeding, ovulatory dysfunction), particularly in women > 45 years A routine Papanicolaou (Pap) test showing endometrial cells in postmenopausal women A routine Pap test showing atypical endometrial cells in any woman If endometrial cancer is suspected, outpatient endometrial biopsy is done; sensitivity is > 90%.