Ultrasound effective in screening for endometrial cancer

Transvaginal ultrasound screening can detect endometrial cancer before symptoms appear in postmenopausal women, according to research from the U.K.

In a large-scale study to assess the performance of transvaginal ultrasound screening for endometrial cancer, a research team led by Ian Jacobs, of University College London, found that the modality yielded 81% sensitivity and 86% specificity.
The researchers analyzed data from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), in which transvaginal ultrasound screening was performed on 37,038 women (Lancet Oncology, December 13, 2010).
Performance characteristics of endometrial thickness and endometrial abnormalities at detecting endometrial cancer within one year of transvaginal ultrasound screening were calculated. The researchers then evaluated the method's sensitivity and specificity for different risk groups, and the group performed modeling using epidemiological variables to assess a screening strategy for women at higher risk.
Of the 133 women diagnosed with endometrial cancer or atypical endometrial hyperplasia within one year of screening, 107 (81%) had an endometrial thickness of 5 mm or more. Most of the 36,731 women who did not have cancer had an endometrial thickness of less than 5 mm, according to the researchers.
At the optimum cutoff of 5.15 mm, transvaginal ultrasound would detect 80.5% of cancer cases, with a false-positive rate of 14.3% (85.7% specificity), they found. With this screening threshold, one case of endometrial cancer would be detected for every 47.7 women screened, according to the researchers.
The authors noted, however, that further studies are needed to examine transvaginal ultrasound screening's acceptability, health economics, and risk before routine population screening or targeted screening can be advocated.


by : Erik L. Ridely
published online in the Lancet Oncology.