A new study published in JAMA Oncology reveals that transvaginal ultrasounds, a common screening method for endometrial cancer, may be unreliable for Black women. The research, led by Dr. Kemi M. Doll from the University of Washington School of Medicine, found that this widely used technique could miss a significant number of cancer cases in Black patients.
The retrospective study analyzed 1,494 ultrasound scans of Black patients who underwent hysterectomies between 2014 and 2020. Results showed that using the standard 5 mm endometrial thickness threshold, there was an 11.4% chance of failing to identify endometrial cancer. Even at lower thresholds, the risk remained concerning.
Dr. Doll emphasized the unacceptability of these findings, stating, “What we found in real-world clinical scenarios, is that [transvaginal ultrasound] is just not accurate enough to be safely employed as a strategy among Black [patients]. Whereas a tissue biopsy is conclusive.”
The study revealed that factors such as the presence of fibroids, pelvic pain, and an enlarged uterus were more prevalent in cases where cancer was missed. Additionally, a longer interval between ultrasound and hysterectomy was observed in these cases.
Given these results, the researchers strongly recommend tissue sampling for Black patients presenting with postmenopausal bleeding, rather than relying on ultrasound screening alone. This study highlights a critical disparity in cancer detection methods and underscores the need for more tailored approaches to ensure accurate diagnosis across all racial groups.
See “Transvaginal Ultrasounds May Not Detect Endometrial Cancer in Black Women” (July 2, 2024)
