Can Transvaginal Ultrasound Scan Be Used as a Screening Method for Endometrial Cancer in Postmenopausal Women?

Introduction Endometrial cancer is the commonest cancer of the female genital tract in the developed world. Considering the rising incidence of endometrial cancer, there is now a need to evaluate screening methods for endometrial cancer. Objectives To assess the efficiency, feasibility and cost benefits of the TV ultrasound scan in post menopausal asymptomatic women in order to detect endometrial anomalies. Methods We routinely scanned in 1-year period 239 women who were seeking medical advice for different complaints other than metrorrhagia. Standard ultrasound sections were obtained, endometrial thickness cut off was set at 4 mm. We divided the patients in 2 groups:one with borderline endometrial thickness (5-8 mm) and the other one with frankly abnormal endometrial thickness (>9 mm). Patients with borderline anomalies were scheduled for follow up at 3 months. Patients in the second group underwent dilatation and curettage (DC). Results 19 women had abnormal endometrial thickness, some had endometrial polyps, other insignificant findings as myomas, uterine cavity fluid with thin endometrial cysts of the cervix and one had even an abnormal cervical circulation. We performed 7 DC with 3 endometrial hyperplasia with atypia, 1 uterine ADK and 1 uterine polyp and 2 hyperplasia without atypia. Patients with pathology undergone surgery.12 patients had bordeline abnormal endometrium and only 2 needed DC after the second examination. Conclusions The ultrasound examination is cheap, noninvasive, and accepted and proved to be efficient in detection of endometrial abnormalities and can be offered as a screening method for endometrial cancer.