Screening tool frequently misses this cancer in Black women, study finds

Transvaginal ultrasound, or TVUS, a screening tool for endometrial cancer, often misses cases among Black women, according to research published July 15 in JAMA Oncology.

The screening tool is often used to determine whether a biopsy is needed, and measures the thickness of the endometrial or uterine lining.  

The simulated cohort study pulled data from a national cancer registry and the U.S. census. It included 367,073 simulated Black and White women with postmenopausal bleeding, including 36,708 with endometrial cancer. 

Findings showed TVUS screening missed over four times more cases of endometrial cancer among Black women compared to white women. 

This is likely due to the greater prevalence of fibroids and non-endometrioid histology type that occurs among Black women, researchers said. TVUS measures lining thickness, though "not all endometrial cancer increase the lining thickness," said Kemi Doll, MD, lead researcher and a gynecologic oncologist at the University of Washington School of Medicine in Seattle. 

"This puts Black women at a higher risk of false-negative results," she said. "That is unacceptable in a group that is already the most vulnerable to the worst outcomes of endometrial cancer." 

While a real-world study is needed to confirm the findings, they indicate clinicians should be cautious to rule out the need for a biopsy solely based on TVUS screening, researchers said. 

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