According to a study, from the University College London, Transvaginal ultrasound features high specificity and sensitivity for diagnosing endometrial cancer. The researchers discovered that transvaginal ultrasound is useful for high-risk groups prone to endometrial cancer and especially in the management of postmenopausal females subjecting to pelvic scans for causes different from vaginal bleeding.
The most common gynecological cancer in Europe is endometrial cancer, and in many northern and western European countries it has a rising occurrence in postmenopausal females. Overall occurrence of endometrial cancer in the U.K increased from 13.5 per 100,000 in 1993 to 17.9 per 100,000 in 2005. Two risk factors for endometrial cancer are the fall in fertility rates and the raise in obesity, suggest that the occurrence of endometrial cancer will keep up increasing in postmenopausal females and the authors mentioned that will be a major public health problem all over the world.
So far, there is no imaging exam for asymptomatic females in order to diagnosis endometrial cancer in an early stage. For symptomatic women, transvaginal ultrasound (TVS) and endometrial sampling are used to evaluate the endometrium. Thicker endometria are contributed with endometrial cancer. Ian Jacobs and his colleagues from the Gynecological Oncology department at University College London operated a nested case-control study of postmenopausal females who used TVS in the Collaborative Trial of Ovarian Cancer imaging, which involved 37,038 females.
Using an endometrial thickness cutoff of 5.15mm, TVS has 80.5% sensitivity and 86.2% specificity. Using this threshold, if the entire population was imaged, one case of endometrial cancer would be diagnosed for each 47.7 females imaged. Using an endometrial thickness cutoff of 10 mm or greater, TVS has 54.1% sensitivity and 97.2% specificity.
The researching team reported “Although the role of population screening for endometrial cancer remains uncertain, the findings are of immediate value in the management of increased endometrial thickness in postmenopausal women undergoing pelvic scans for reasons other than vaginal bleeding,”
Dr. Michael Blumenfeld, an associate professor in the ob/gyn department at Ohio State University Medical Center and the clinical director of the center for female’s health explained that the study lets doctors use TVS to triage the results in asymptomatic patients as opposed to using it as a pure imaging mechanism. Moreover, he noted “To be a screening test TVS has to affect and improve survival .There is no evidence from a prospective study that it’s going to change the long-term outcome.”
In addition, Blumenfeld mentioned that the study for radiologist will offer data on what they discover. TVS will finish being a part of the pelvic test in all like hood. He also reported “If a doctor scans for reasons such as an ovarian mass, and then finds an endometrial thickness, he or she needs to know how to triage the patient, this study helps with that.”
Besides, Jacob explained that this study has created the basis for further research. Particularly, topics of morbidity, early diagnosis, health economics of intervening on the basis of endometrial thickness and acceptability will be necessary as they are going to be the subject of future studies.
