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Intermittent occasional spotting can be a symptom of endometrial cancer. Other symptoms could be spotting after intercourse, a slightly darker than normal vaginal discharge, or crampy feeling. These of course are also symptoms of peri-menopause, that's what makes it difficult to detect endometrial cancer in its earliest stages if it develops prior to menopause. It does not show up on a PAP smear. However, Uterine ultrasound or a D&C are used to diagnose this condition. The actress Fran Dresser? (tv show the Nanny) spent a year going to doctors before getting a correct diagnosis. She wrote a book about it that can be gotten from the library. If you have a family history -parents, siblings, grandparents, aunts, uncles who have had colon cancer, uterine cancer, ovarian, breast or prostate cancer, it is a possibility that there would be a greater than average chance of developing it. I was lucky my periods had already stopped for over a year before the occasional spotting started, so I knew something abnormal was occuring.