For Black adults at risk for endometrial cancer (EC), a transvaginal ultrasonography triage strategy is not reliable, according to a study published in JAMA Oncology. Kemi Doll, MD, and colleagues examined false-negative probability using ultrasonography-measured endometrial thickness (ET) thresholds as triage for EC diagnosis among Black patients who underwent hysterectomy. The sample included 1,494 patients with a uterus; 210 had EC. The most common diagnoses within 30 days of ultrasonography were fibroids (78.1%), vaginal bleeding (71.4%), and pelvic pain (57.4%). There was an 11.4% probability that someone with EC would be classified as not having EC by applying the less than 5-mm ET threshold. At the 4-mm and 3-mm thresholds, the probability was 9.5% and 3.8%, respectively. At the 5-mm threshold, false-negative probability was similar among EC risk factors, including postmenopausal bleeding, high BMI (>40), and increasing age (≥50). Among those with fibroids found in a ultrasonography, probability was higher with reported partial ET visibility (26.1%) and pelvic pain (14.5%).
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