The No. 1 recommendation to fight endometrial cancer is to catch it early.
But new research from JAMA Network found that Black women may be losing valuable time in that battle, because the most common test used to detect the disease isn’t as conclusive as doctors once believed.
“These screenings often lead us to false negatives in Black women,” said Dr. Trashawn Thornton-Davis, an OB/GYN at Kaiser Permanente in Silver Spring, Maryland. “We may be missing many cases.”
A tissue biopsy is strongly recommended in Black patients to rule out endometrial cancer, instead of using a transvaginal ultrasound to discover the disease.
“Ultrasounds are great. They can tell us a lot of information,” Thornton-Davis said. “But when it comes down to ruling out cancer in the lining of the uterus, you need tissue sampling, not just ultrasound alone.”
A transvaginal ultrasound is an imaging technique doctors use to view a woman’s pelvic organs. It also allows doctors to measure the thickness of the lining of a woman’s womb, which is an indicator of endometrial cancer. The test is supposed to be highly accurate. But for many Black women, it isn’t.
Thornton-Davis said Black women face a couple of hurdles, chief among them: fibroids.
“Fibroids can distort what the lining of the uterus looks like on ultrasound,” she told WTOP. “They can also have a greater prevalence of nonendometroid types of cancer, which don’t also detect by sonogram. This is why we can see missed cases in Black women.”
The research tracked more than 1,500 Black women, who ended up undergoing hysterectomies. The women who are most at risk of developing the disease are postmenopausal women 50 years and older.
The number of endometrial cancer cases is increasing, especially among Black women, who are more likely to be diagnosed with the disease at a later stage, according to the University of Washington School of Medicine.
In addition to advocating for tissue biopsies, Thornton-Davis said she offers her patients a couple of tips to catch endometrial cancer early or decrease their risk of developing it. She recommends reporting any symptoms or changes in health, including pelvic pain, difficulty urinating and postmenopausal bleeding to their doctor.
“And manage your weight,” Thornton-Davis said. “When you hear obesity and weight puts you at risk for cancer, this is one of the cancers that’s being referred. Just try to get your weight down because the more you lose, it’s going to improve your overall wellness.”