Endometrial cancer remains the most common gynecologic malignancy in the United States, and Black women continue to bear a disproportionate share of its deadliest outcomes. New research highlighted by Contemporary OB/GYN suggests that earlier use of endometrial biopsy, combined with trust-building and shared decision-making, could improve timely detection among symptomatic Black women and help reduce long-standing racial disparities.
Black women experience more than twice the five-year mortality of White patients with endometrial cancer, a difference driven largely by later-stage diagnosis. There are no routine screening tests for early detection, and transvaginal ultrasound, often used as an initial step, may be less accurate in Black patients. Researchers examined whether a biopsy-first approach could address this gap by prioritizing diagnostic accuracy earlier in the evaluation process.
Focus groups with Black women revealed deep skepticism shaped by past medical experiences. Participants described fear, anxiety, and feelings of dehumanization during prior gynecologic procedures, often rooted in experiences of dismissal and medical racism. One participant said, “I think that we, as women of color, are completely dismissed… especially when it comes to our femininity.” Initial resistance to biopsy reflected concerns about pain, invasiveness, and lack of clear explanation.
Attitudes shifted when education and transparency were introduced. After learning about endometrial cancer risk, biopsy accuracy, and individualized clinical indicators, participants overwhelmingly favored a more accurate test, even if invasive. Trust in providers, acknowledgment of medical racism, and racial concordance in care were cited as key factors influencing acceptance. Another participant emphasized informed choice, saying she needed providers to “talk to me about my hormone levels and my blood cell levels” before agreeing to biopsy.
The findings point to a clear message: addressing racial health disparities in endometrial cancer requires more than new tools. Earlier diagnosis depends on patient-centered care that respects lived experience, rebuilds trust, and ensures Black women receive timely, accurate evaluation when symptoms first appear.
See: “Early biopsy may improve endometrial cancer detection among symptomatic Black women” (October 9, 2025)
