Ultrasound screening often misses signs of endometrial cancer in Black women, according to a new study in JAMA Oncology.
African American women in the U.S. have a 90% higher mortality rate after being diagnosed with this disease compared to their white peers. Prior research has assessed this disparity as an access issue, but oncology experts analyzed imaging guidelines themselves for their July 15 investigation.
Using a simulated population, University of Washington Medicine doctors found transvaginal ultrasound, or TVUS, screening missed at least four times more cancer cases among Black versus white women.
The findings suggest relying solely on TVUS to determine if a biopsy is warranted is not enough to close this care equity gap.
"This puts Black women at a higher risk of false-negative results," lead researcher Kemi Doll, MD, a gynecologic oncologist at UW Medicine in Seattle, said Thursday. "That is unacceptable in a group that is already the most vulnerable to the worst outcomes of endometrial cancer."
Current TVUS guidelines were informed by population-based studies from Scandinavia, Italy and Hong Kong; Black women were not included. Additionally, not all endometrial cancer increases lining thickness, Doll noted, making it difficult to recommend biopsy.
With this in mind, the group utilized data from a national cancer registry and U.S. Census information to create two representative patient groups. In total, the cohorts included 367,000 Black and white women with postmenopausal bleeding, and more than 36,000 with endometrial cancer.
Doll and colleagues suggest a real-world clinical study to confirm their findings but cautioned against relying only on TVUS for screening this patient population.
Read the entire study here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.