핵심 개념
Transvaginal ultrasonography-based endometrial thickness triage strategy has a significant risk of false-negative results for endometrial cancer diagnosis in high-risk Black women.
초록
The study assessed the performance of transvaginal ultrasonography-measured endometrial thickness as a diagnostic triage strategy for endometrial cancer in 1,494 Black women who underwent hysterectomy. The researchers focused on endometrial thickness measurements recorded within 24 months before hysterectomy, as well as demographic and clinical data.
The key findings are:
- 210 women had endometrial cancer, with the most common presenting symptoms being fibroids (78%), vaginal bleeding (71%), and pelvic pain (57%).
- 24 cases of endometrial cancer were below the 5-mm endometrial thickness threshold that would trigger biopsy, resulting in 11.4% of endometrial cancer cases potentially missed.
- The false-negative probability was 9.5% (20 cases) at the < 4-mm threshold and 3.8% (8 cases) at the < 3-mm threshold.
- Classic risk factors for endometrial cancer did not improve the performance of the endometrial thickness triage strategy.
- False-negative probability was also higher in the setting of partial endometrial thickness visibility (26%) and pelvic pain (15%).
The researchers concluded that the transvaginal ultrasonography triage strategy is unreliable for diagnosing endometrial cancer in high-risk Black women, with a significant risk for false-negative results. They recommend tissue biopsy for Black patients with concerning symptoms to avoid misdiagnosis of endometrial cancer.
통계
24 cases of endometrial cancer were below the 5-mm endometrial thickness threshold that would trigger biopsy, resulting in 11.4% of endometrial cancer cases potentially missed.
The false-negative probability was 9.5% (20 cases) at the < 4-mm threshold and 3.8% (8 cases) at the < 3-mm threshold.
False-negative probability was higher in the setting of partial endometrial thickness visibility (26%) and pelvic pain (15%).
인용구
"This study reveals a 'concerning error rate for a triage strategy that would terminate further workup and provide false reassurance to both patients and physicians.'"
"For Black patients with concerning symptoms, tissue biopsy is recommended to avoid misdiagnosis of endometrial cancer."