Ultrasound Screening Less Effective in Black Women

Ultrasound Screening Less Effective in Black Women

A New Report Reveals a Significant Gap in Endometrial Cancer Detection

A recent study published in JAMA Oncology has found that a common screening technique used to assess the risk of endometrial cancer (EC) may be less effective in Black people. The study, which evaluated the health data of 1,494 Black individuals who underwent pelvic ultrasonography with an endometrial thickness (ET) measurement before a hysterectomy, revealed that pelvic transvaginal ultrasonography (TVUS) misses a significant percentage of cancer risk cases in Black females.

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The Study’s Findings

The study found that approximately 11% of cancers detected in Black females were detected below the diagnostic threshold for detection (4 mm). Moreover, 3.8% of cancers were detected in individuals who had an ET less than 3 mm. An estimated 11.5% of the cancers would have been missed because the individuals had a relatively thin ET.

The Importance of Tissue Biopsy

The study’s findings suggest that the most accurate way to identify EC in Black females is through a tissue biopsy. The researchers emphasize that relying solely on TVUS may not be sufficient to detect EC in this population.

Health Inequities in Endometrial Cancer Diagnosis and Treatment

The study’s lead researcher, Dr. Kemi Doll, has significantly added to the scant research that’s been done surrounding health inequities in the diagnosis and treatment of endometrial cancer. The main takeaway from the study is that we cannot rely simply on the image we see on an ultrasound report to determine whether to biopsy a patient with postmenopausal bleeding.

TVUS: An Effective Screening Technique in Many Patient Populations

In many patient populations, TVUS is an effective way to measure ET and provide a risk assessment for EC. However, the procedure doesn’t appear to be as reliable in Black females. Prior research has shown that Black females with postmenopausal bleeding are less likely to get an endometrial biopsy.

Higher Prevalence of Aggressive Types of Endometrial Cancer

The researchers suspect that the decreased visibility of the cancers in Black females and the increased prevalence of fibroids may make the cancer harder to detect via TVUS alone. Additionally, the higher prevalence of aggressive types of endometrial cancer that present with thinner linings among Black patients may also contribute to the decreased accuracy of TVUS.

A Call to Action for Physicians

The researchers suggest that a tissue biopsy should always be done to provide an accurate diagnosis of EC. They urge physicians to refer patients to gynecologists when they report bleeding regardless of how thick the inner lining of their uterus is.

Conclusion

The study’s findings highlight the need for a more accurate and effective screening technique for endometrial cancer in Black females. The results emphasize the importance of a tissue biopsy in detecting EC in this population. Physicians should be aware of the limitations of TVUS in detecting EC in Black females and consider a tissue biopsy as part of the diagnostic workup.

FAQs

Q: What is the most accurate way to detect endometrial cancer in Black females?
A: The most accurate way to detect endometrial cancer in Black females is through a tissue biopsy.

Q: Why is TVUS less effective in detecting endometrial cancer in Black females?
A: TVUS may be less effective in detecting endometrial cancer in Black females due to the decreased visibility of the cancers and the increased prevalence of fibroids.

Q: What is the significance of the study’s findings?
A: The study’s findings highlight the need for a more accurate and effective screening technique for endometrial cancer in Black females. The results emphasize the importance of a tissue biopsy in detecting EC in this population.

Q: What is the call to action for physicians?
A: Physicians should refer patients to gynecologists when they report bleeding regardless of how thick the inner lining of their uterus is.