Transvaginal ultrasonography triage resulted in misclassification for more than one in 10 Black women, suggesting it is not a reliable strategy to identify Black women at risk for endometrial cancer, according to a new diagnostic study. The research, published in JAMA Oncology, analyzed data from 1,494 Black women who underwent hysterectomy between 2014 and 2020. Of these, 210 were diagnosed with endometrial cancer.
Current guidelines recommend transvaginal ultrasonography for women with postmenopausal bleeding, with endometrial tissue sampling advised for those with an endometrial thickness of 4 mm or greater. However, the study found significant shortcomings in this approach for Black women.
False-negative probabilities increased with higher endometrial thickness thresholds, reaching 11.4% at the 5 mm threshold. Black women with fibroids, partially visible endometrial thickness, or pelvic pain had even higher false-negative probabilities, ranging from 13% to 26.1%.
Dr. Kemi M. Doll, lead researcher from the Fred Hutchinson Cancer Center at the University of Washington, emphasized the implications of these findings. “These findings suggest that the transvaginal ultrasonography triage strategy is not reliable among Black adults at risk for endometrial cancer,” the researchers wrote.
The study highlights a critical racial disparity in endometrial cancer detection methods. The researchers strongly recommend tissue sampling in the presence of postmenopausal bleeding, particularly for Black women. This research underscores the need for more inclusive and effective diagnostic strategies in women’s health, especially for underrepresented populations.
See “Transvaginal ultrasonography unreliable in identifying endometrial cancer for Black women” (July 3, 2024)
