Only 22% of women ages 18 to 44 can name all five gynecological cancers. Even less are familiar with the symptoms, according to a study conducted by representatives for the Lady Garden Foundation, a United Kingdom charity founded in 2014 to raise awareness of women’s health concerns. Although this was a U.K.-based study, earlier studies conducted in the United States yielded similar results.

The five gynecological cancers—cervical, ovarian, uterine/endometrial, vaginal and vulvar—constitute a significant amount of the worldwide cancer burden. In the United States, 94,000 women are diagnosed with one such cancer each year, according to the Centers for Disease Control and Prevention (CDC).

Despite their statistical prevalence, these cancers are seldom caught early, earning them the nickname “silent killers.” In 2018, for example, ovarian cancer accounted for 2.5% of all cancers diagnosed in women in the United States but 5% of all cancer-related deaths. One reason for their high mortality rate is insufficient education about risk factors, physical symptoms and screening options.

Sure enough, when read a list of 19 common gynecological cancer symptoms, 86 out of the 100 participants said they had not known that some or all of those listed—including bloating, weight changes and extreme fatigue—were potentially indicative of tumor development.

According to the CDC, physical characteristics and conditions that warrant medical attention but do not necessarily signify cancer, include unusual or persistent vaginal bleeding between periods, after sex or after menopause; pelvic pain or pressure; constipation; and frequent urination. (To learn more, see the CDC’s public health campaign, “Inside Knowledge About Gynecologic Cancer.”)

Gynecological cancer most often develops during or following menopause due to changes in a woman’s hormonal profile. Risk factors include infertility, overweight or obesity, infection by one or more of the 12 strains of human papillomavirus known to cause abnormal cell division, and family history. One recent innovation in preventive care is the HPV vaccine, which provides immunity against the cancer-causing strains of HPV and is recommended for children ages 11 or 12.

Speaking to Forbes, Jenny Halpern Prince, the cofounder and chair of the Lady Garden Foundation, said gynecological cancer mortality rates may wind up being even higher this year. “The COVID-19 pandemic has disrupted all our lives, but the knock-on effect it will have on cancer diagnosis and survival rates is frightening,” she said. “It’s more important now than ever that we visit our clinician with any concerns. Knowing the symptoms and getting an early diagnosis can save lives. It’s as simple as that.”

To read about recent changes to cervical cancer screening best practices, click here. And to read about how your HIV status might affect access to gynecological cancer care, click here.