• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Is There Any Benefit to Diagnosing Endometrial Cancer in Asymptomatic Women?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Screening for endometrial cancer is not currently recommended, although ultrasound has the potential to identify disease at an early stage
  • Transvaginal ultrasound can detect endometrial cancer in asymptomatic patients
    • Endometrial thickness >11mm: 6.7% of cases will have an endometrial cancer diagnosis
    • Postmenopausal polyps: 0.87-2.31% will have an endometrial cancer diagnosis
  • Gerner et al. (AJOG 2018) compared the survival of postmenopausal patients who had endometrial cancer diagnosed prior to symptoms vs those who presented with bleeding

METHODS:

  • Retrospective multicenter study
  • Data of consecutive patients who were followed up from date of surgery until an event
    • Recurrence
    • Death from endometrial cancer
    • Death
    • Follow up to 10 years
  • Two patient cohorts (postmenopausal) were compared
    • Asymptomatic
    • bleeding
  • Primary outcomes include the following measures
    • Clinical | Pathological | Survival

RESULTS:

  • 1,607 patients were included
    • 233 asymptomatic (usually endometrial thickening following routine transvaginal ultrasound examination)
    • 1374 presented with postmenopausal bleeding
  • Asymptomatic patients did not have a lower rate of advanced disease (II–IV) or high-grade histology
  • Among patients with stage-I tumors, asymptomatic patients had
    • A greater proportion than postmenopausal bleeding patients of stage IA (82.1% vs 66.2%; P < .01)
    • A smaller proportion received adjuvant postoperative radiotherapy (30.5% vs 40.6%; P = .02)
  • There was no difference between asymptomatic and postmenopausal bleeding patients in the following
    • The 5-year recurrence-free survival (79.1% vs 79.4%; P = .85)
    • Disease-specific survival (83.2% vs 82.2%; P = .57)
    • Overall survival (79.7% vs 76.8%; P = .37)

CONCLUSION:

  • The difference in timing between asymptomatic and symptomatic detection allows early cancers to further penetrate the endometrium, but not result in metastases or worsening histology
  • Treatment in asymptomatic postmenopausal women was not associated with higher survival rate
  • This study agrees with previous literature that there does not appear to be an advantage to using ultrasound to screen for endometrial cancer
  • The authors recognize limitations to this study, including retrospective design, and note that RCTs would be worthwhile
  • In addition, they recommend that based on the results of this study, asymptomatic women with endometrial polyps or thickening could be carefully followed up with repeat 3-month ultrasounds
    • Bleeding or other symptoms should generate invasive confirmatory testing

Learn More – Primary Sources:

Is there a survival advantage in diagnosing endometrial cancer in asymptomatic postmenopausal patients? An Israeli Gynecology Oncology Group study

image_pdfFavoriteLoadingFavorite

< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Transvaginal Ultrasound in the Evaluation of Postmenopausal Bleeding
Ovarian or Endometrial Cancer? Consider Lynch Syndrome
Endometrial Cancer: The Basics

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site