A recent study highlights significant disparities in the effectiveness of ultrasound for detecting endometrial cancer in Black women. Research led by Dr. Angela Nolin from Duke University reveals that ultrasound-based strategies fall short compared to biopsy-based methods, particularly for non-Hispanic Black women with postmenopausal bleeding. The study, published in Gynecologic Oncology, underscores that fibroids, more prevalent in Black women, hinder endometrial visualization, leading to inadequate cancer detection.
The researchers developed a decision-tree model to compare ultrasound and biopsy strategies.
In a simulated cohort of 10,000 women, ultrasound missed 109 cancer diagnoses, while biopsy missed 70. For Black women, ultrasound missed 114 cancers, including 43 high-grade cases, compared to 106 missed in white women, with 17 high-grade cases. This disparity suggests that biopsy-based strategies offer higher value for Black women, detecting more cancers with fewer biopsies.
Dr. Nolin’s team emphasizes that delays in diagnosis due to ultrasound’s limitations may exacerbate survival disparities. They advocate for offering endometrial sampling at the initial evaluation for postmenopausal bleeding, especially for Black women. This approach could mitigate the impact of fibroids and improve cancer detection rates, addressing a critical gap in healthcare equity.
See: “Ultrasound falls short for detecting endometrial cancer in Black women” (February 21, 2025)
