OBJECTIVES: Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding, but the role of endometrial thickness measurement by ultrasound in asymptomatic women is unclear. The aims of this study were to determine: (1) the normal endometrial thickness measured by ultrasonography, (2) the prevalence of serious endometrial pathology and (3) the sensitivity and specificity of endometrial thickness measurement by transvaginal ultrasonography (TVS) for diagnosing premalignant and malignant endometrial disease in asymptomatic postmenopausal women. METHODS: A MEDLINE and EMBASE search (from inception to January 2011) was performed. Articles reporting on endometrial thickness measurement in the diagnosis of endometrial carcinoma and atypical hyperplasia in asymptomatic postmenopausal women not using hormone replacement therapy (HRT) were selected. Endometrial thickness and the prevalence of endometrial (pre)malignancies were recorded. If possible, 2 × 2 tables were extracted. RESULTS: Thirty-two studies reporting on 11100 women were included. The estimated mean endometrial thickness was 2.9 mm (95% CI, 2.6-3.3 mm). The pooled estimated prevalences of endometrial carcinoma and atypical endometrial hyperplasia were 0.62% (95% CI, 0.42-0.82%) and 0.59% (95% CI, 0.22-0.96%), respectively. Summary estimates for sensitivity and specificity of TVS endometrial thickness measurement in the prediction of endometrial carcinoma were 0.83 (95% CI, 0.19-1.00) and 0.72 (95% CI, 0.23-0.95) for a 5-mm cut-off and 0.33 (95% CI, 0.04-0.85) and 0.94 (95% CI, 0.92-0.96) for a 6-mm cut-off. CONCLUSIONS: The results from this systematic review do not justify the use of endometrial thickness as a screening test for endometrial carcinoma and atypical endometrial hyperplasia in asymptomatic postmenopausal women not using HRT.
OBJECTIVES: Measurement of endometrial thickness is an important tool in the assessment of women with postmenopausal bleeding, but the role of endometrial thickness measurement by ultrasound in asymptomatic women is unclear. The aims of this study were to determine: (1) the normal endometrial thickness measured by ultrasonography, (2) the prevalence of serious endometrial pathology and (3) the sensitivity and specificity of endometrial thickness measurement by transvaginal ultrasonography (TVS) for diagnosing premalignant and malignant endometrial disease in asymptomatic postmenopausal women. METHODS: A MEDLINE and EMBASE search (from inception to January 2011) was performed. Articles reporting on endometrial thickness measurement in the diagnosis of endometrial carcinoma and atypical hyperplasia in asymptomatic postmenopausal women not using hormone replacement therapy (HRT) were selected. Endometrial thickness and the prevalence of endometrial (pre)malignancies were recorded. If possible, 2 × 2 tables were extracted. RESULTS: Thirty-two studies reporting on 11100 women were included. The estimated mean endometrial thickness was 2.9 mm (95% CI, 2.6-3.3 mm). The pooled estimated prevalences of endometrial carcinoma and atypical endometrial hyperplasia were 0.62% (95% CI, 0.42-0.82%) and 0.59% (95% CI, 0.22-0.96%), respectively. Summary estimates for sensitivity and specificity of TVS endometrial thickness measurement in the prediction of endometrial carcinoma were 0.83 (95% CI, 0.19-1.00) and 0.72 (95% CI, 0.23-0.95) for a 5-mm cut-off and 0.33 (95% CI, 0.04-0.85) and 0.94 (95% CI, 0.92-0.96) for a 6-mm cut-off. CONCLUSIONS: The results from this systematic review do not justify the use of endometrial thickness as a screening test for endometrial carcinoma and atypical endometrial hyperplasia in asymptomatic postmenopausal women not using HRT.
Authors: Ashley S Felix; Joel L Weissfeld; Ruth M Pfeiffer; Francesmary Modugno; Amanda Black; Lyndon M Hill; Jerry Martin; Anita S Sit; Mark E Sherman; Louise A Brinton Journal: Int J Cancer Date: 2013-08-28 Impact factor: 7.396
Authors: Khaled El-Shami; Kevin C Oeffinger; Nicole L Erb; Anne Willis; Jennifer K Bretsch; Mandi L Pratt-Chapman; Rachel S Cannady; Sandra L Wong; Johnie Rose; April L Barbour; Kevin D Stein; Katherine B Sharpe; Durado D Brooks; Rebecca L Cowens-Alvarado Journal: CA Cancer J Clin Date: 2015-09-08 Impact factor: 508.702
Authors: Anika Hüsing; Laure Dossus; Pietro Ferrari; Anne Tjønneland; Louise Hansen; Guy Fagherazzi; Laura Baglietto; Helena Schock; Jenny Chang-Claude; Heiner Boeing; Annika Steffen; Antonia Trichopoulou; Christina Bamia; Michalis Katsoulis; Vittorio Krogh; Domenico Palli; Salvatore Panico; N Charlotte Onland-Moret; Petra H Peeters; H Bas Bueno-de-Mesquita; Elisabete Weiderpass; Inger T Gram; Eva Ardanaz; Mireia Obón-Santacana; Carmen Navarro; Emilio Sánchez-Cantalejo; Nerea Etxezarreta; Naomi E Allen; Kay Tee Khaw; Nick Wareham; Sabina Rinaldi; Isabelle Romieu; Melissa A Merritt; Marc Gunter; Elio Riboli; Rudolf Kaaks Journal: Eur J Epidemiol Date: 2015-05-13 Impact factor: 8.082