A transvaginal ultrasound—a test doctors use to check for signs of endometrial cancer—may not always give clear results for Black women, according to a recent study published in the Journal of Women’s Health.
Black women are also more likely to be diagnosed with aggressive (fast-growing and spreading) types of endometrial cancer and have overall poorer health outcomes compared to white patients.
Typically, doctors use transvaginal ultrasound to check the thickness of the uterine lining and decide whether a biopsy is needed to look for uterine cancer. (A biopsy is when a small piece of tissue from the uterus is removed and examined under a microscope to check whether there are cancer cells or other abnormal changes.)
In this study, researchers looked at the medical records of 2,705 Black women who had hysterectomies (surgical removal of the uterus) between 2014 and 2020. They found that in almost 30% of cases, the ultrasound couldn’t clearly show the uterine lining. In about one in 10 cases, ultrasound gave no information at all about the lining.
The researchers identified two main factors that made it harder for ultrasounds to work well: fibroids (noncancerous growths in the uterus) and an enlarged uterus.
Read more about endometrial cancer treatment and care
Because ultrasounds so often fail to give answers in women with fibroids or large uteruses, the researchers suggest that doctors take a different diagnostic approach: skipping the ultrasound and going straight to a biopsy, which can more reliably detect cancer or rule it out.
The researchers warn that unclear ultrasound results may cause delays in diagnosis, missed cancers and worse survival outcomes for Black women. “Improved diagnostic approaches are needed in this population,” they said.
They hope their findings will help guide better screening strategies so patients get the answers and care they need sooner.
