Researchers found that transvaginal ultrasound screening can show many cases of endometrial cancer in postmenopausal women before any appearance of symptoms. According to Ian Jacobs, MD, of University College London, and colleagues more than 80% of cases can be determined by this test and about 15% of them is false.
Jacobs and colleagues reported online in The Lancet Oncology that in order to develop the sensitivity and specificity, the ultrasound screening would be restricted to a high-risk population. Many experts disagree with this technique as it can't be cost-effective. Jonathan Berek, MD, of Stanford University School of Medicine in Stanford, Calif, said in an e-mail "Symptoms usually vaginal bleeding will be improved in all women with endometrial cancer before it spreads. Once symptoms appear the diagnosis will be performed by an endometrial biopsy".
Jacobs and colleagues mentioned that although endometrial cancer is the most common gynecological cancer and it has usually a good warning, there isn't enough information about the role of screening in women without symptoms. Jacobs and colleagues performed an experiment as they conducted a nested case-control study within the United Kingdom Collaborative Trial of Ovarian Cancer Screening. In this experiment 48,230 women were examined by transvaginal ultrasound, and it was found that more than 11,000 were ineligible for this analysis due to they had had a hysterectomy or due to they didn't have endometrial thickness recorded, leaving a cohort of 37,038 women.
After the examination, researchers found 136 women improved endometrial cancer in less than a year from their ultrasound. On the other hand, Jacobs and colleagues found that 81% had an endometrial thickness of at least five millimeters, while 83% of those who did not have the disease had a thickness of less than five millimeters.
Ignace Vergote, MD, PhD, and colleagues from University Hospitals Leuven in Leuven, Belgium commented that this study gave very important information about screening for endometrial cancer.
