Transvaginal ultrasounds fail to detect endometrial cancer in up to 11.4% of Black women, according to research from a Seattle-based University of Washington study published June 27 in JAMA Oncology.
Researchers studied the outcomes of 1,494 Black patients who had hysterectomy procedures at 10 hospitals. They found when using a 5-millimeter threshold for endometrial thickness, 11.4% of patients with endometrial cancer were inaccurately classified.
Lowering the measurement threshold reduced false classification of the condition, according to the study. When it was brought down to 4 millimeters, that reduced the false-negative rate to 9.5%. Going down to 3 millimeters further lowered the rate to 3.8%.
In cases where an ultrasound was showing only part of the endometrium, inaccurate classifications went up to 26% in Black patients.
"The transvaginal ultrasonography triage strategy is not reliable among Black adults at risk of [endometrial cancer] for Black patients with concerning symptoms," researchers wrote, underscoring that "tissue biopsy is recommended to avoid misdiagnosis of EC."