An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms.

Abstract

OBJECTIVE:

Our purpose was to evaluate the use of transvaginal ultrasonography for the detection of endometrial disease in a population of postmenopausal women who were without symptoms.

STUDY DESIGN:

Postmenopausal women were screened for potential inclusion in 2 multicenter, double-blind, placebo-controlled studies of 2 years' duration to evaluate the safety and efficacy of idoxifene in the prevention of osteoporosis. Baseline endometrial evaluation was performed by transvaginal ultrasonography and aspiration biopsy of the endometrium.

RESULTS:

A total of 1926 women were screened by transvaginal ultrasonography, and 1833 of them had endometrial thickness < or =6 mm. Five cases of endometrial abnormality (adenocarcinoma [n = 1] and atypical hyperplasia [n = 4]) were detected in the 1750 women from this cohort who underwent biopsy. The negative predictive value was >99%. One case of adenocarcinoma was detected in the 42 women who had endometrial thickness >6 mm and underwent biopsy. However, the sampling rate (45%) of women with endometrial thickness >6 mm was too low for confidence in the positive predictive value of 2%.

CONCLUSIONS:

Despite a high negative predictive value, transvaginal ultrasonography may not be an effective screening procedure for detection of endometrial abnormality in untreated postmenopausal women who are without symptoms.

• Authors: A C Fleischer, J E Wheeler, I Lindsay, S L Hendrix, S Grabill, B Kravitz, B MacDonald
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 184 Issue 2 Pg. 70-5 (Jan 2001) ISSN: 0002-9378 [Print] United States
• PMID: 11174482 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Placebos
• Tamoxifen
• idoxifene

Topics

• Adenocarcinoma (diagnostic imaging, pathology)
• Biopsy, Needle
• Double-Blind Method
• Endometrial Hyperplasia (diagnostic imaging, pathology)
• Endometrial Neoplasms (diagnostic imaging, pathology)
• Endometrium (diagnostic imaging, pathology)
• Female
• Humans
• Osteoporosis, Postmenopausal (prevention & control)
• Placebos
• Postmenopause
• Sensitivity and Specificity
• Tamoxifen (analogs & derivatives, therapeutic use)
• Ultrasonography
• Uterine Diseases (diagnostic imaging)