A common screening method for endometrial cancer frequently misses signs of the disease in Black women, potentially contributing to higher mortality rates, according to a new study published in JAMA Oncology.
Researchers found that transvaginal ultrasound (TVUS) screening missed over four times more cases of endometrial cancer in Black women compared to white women. The disparity is attributed to Black women’s higher prevalence of fibroids and different cancer cell types.
“Black women have an over 90% higher mortality rate after diagnosis of endometrial cancer when compared with white women in the U.S.,” said Dr. Kemi Doll, lead researcher and gynecologic oncologist at the University of Washington School of Medicine. “This is a longstanding disparity that we have yet to make meaningful progress to address.”
The study used simulated data to evaluate 367,073 Black and white women with postmenopausal bleeding, including 36,708 with endometrial cancer.
TVUS measures the thickness of the uterine lining to determine if a biopsy is needed. However, not all endometrial cancers increase lining thickness, and fibroids can complicate measurements.
Notably, the TVUS screening method was developed using studies that did not include Black women.
Dr. Doll emphasized the human cost of these findings: “This puts Black women at a higher risk of false-negative results. That is unacceptable in a group that is already the most vulnerable to the worst outcomes of endometrial cancer.”
Researchers recommend that Black women with fibroids discuss biopsy options with their doctors rather than relying solely on TVUS screening.
See “Screening often misses endometrial cancer in Black women” (July 15, 2024)
