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Transvaginal Ultrasound Triage Strategy for Endometrial Cancer Not Reliable for Black Women at Risk

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Significant proportion of those with EC have endometrial thickness below the range of diagnostic threshold for detection on ultrasound

By Elana Gotkine HealthDay Reporter

WEDNESDAY, July 10, 2024 (HealthDay News) — For Black adults at risk for endometrial cancer (EC), a transvaginal ultrasonography triage strategy is not reliable, according to a study published online June 27 in JAMA Oncology.

Kemi M. Doll, M.D., from the University of Washington in Seattle, and colleagues examined false-negative probability using ultrasonography-measured endometrial thickness (ET) thresholds as triage for EC diagnosis among Black individuals who underwent hysterectomy in a retrospective diagnostic study of merged abstracted electronic health record data and secondary administrative data. The sample included 1,494 individuals with a uterus; 210 had EC.

The researchers found that the most common presenting diagnoses within 30 days of ultrasonography were fibroids, vaginal bleeding, and pelvic pain (78.1, 71.4, and 57.4 percent, respectively). There was an 11.4 percent probability that someone with EC would be classified as not having EC by applying the less than 5-mm ET threshold. At the 4-mm and 3-mm thresholds, the probability was 9.5 and 3.8 percent, respectively. At the 5-mm threshold, false-negative probability was similar among EC risk factor groups, including those with postmenopausal bleeding, body mass index >40, and age 50 years or older (12.4, 9.3, and 12.8 percent, respectively). Among those with fibroids on ultrasonography, the false-negative probability was similar (11.8 percent), while probability was higher with reported partial ET visibility and pelvic pain (26.1 and 14.5 percent, respectively).

“Among Black patients who underwent hysterectomy, a significant proportion of those with EC had ET below the range of diagnostic thresholds for detection,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry.

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