December 12th, 2010
07:15 PM ET

Uterine cancer screening effective, but not yet recommended

A diagnostic screening test may be able to detect with more than 80 percent accuracy the early warning signs of uterine cancer in postmenopausal women who show no symptoms, suggests a new study published Sunday in the journal The Lancet.

Researchers in the United Kingdom gave transvaginal ultrasounds to more than 37,000 women who had gone through menopause, and found a strong correlation between having certain abnormal levels of thickness in the uterine wall and a subsequent diagnosis of endometrial cancer.

Despite the promising results, researchers are hesitant to recommend the screening test for all women.

Endometrial cancer forms in the tissue lining the uterus and is the most common cancer of the female reproductive organs according to the American Cancer Society. Each year more than 43,000 women learn they have the condition, and there are nearly 8,000 deaths.

Currently in the U.S., yearly endometrial cancer screenings are recommended only for women who suffer from Lynch syndrome, a rare condition that puts people at increased risk for certain cancers.

The authors of the Lancet study conclude that even though their findings are of "immediate value" and show that an transvaginal ultrasound can detect endometrial cancer before symptoms appear in a high proportion of women, "there are a number of issues that need to be addressed before population screening for endometrial cancer can be proposed."

They note, for example, the possibility of false positives, which they say can be reduced by limiting the diagnostic test to women at high risk for the disease.

"These results are promising," says Robert Smith, director of cancer screening for the American Cancer Society. "But a decision to recommend screening is predicated on determining the right target group and making sure the early diagnostic really makes a difference with a minimal level of harm."

Smith says though routine screening is definitely worth thinking about more carefully, nearly 15 percent of women who undergo the transvaginal ultrasound may require further evaluation that won’t result in cancer, and he says biopsies are intense and expensive. He suggests, however, that if a physician is already doing transvaginal ultrasound for other purposes, then taking note of the endometrial thickness levels found in this study can be used as an indication that further evaluation is needed.

More than half of all endometrial cancer cases are diagnosed in women between ages 50 and 69, and the condition has a high survivability rate when detected early. However Smith notes many postmenopausal women receive a late diagnosis because they overlook a very important warning sign. "The American Cancer Society places a great deal of emphasis of being aware that postmenopausal bleeding is not normal and if it occurs, contact a doctor immediately," he advises.

soundoff (25 Responses)
  1. Stan


    December 12, 2010 at 21:22 | Report abuse | Reply
  2. Mike

    He's got to be kidding... right? Please tell me he's kidding.

    December 12, 2010 at 21:34 | Report abuse | Reply
  3. Fiona

    Guaranteed: if a screening test was discovered that predicted with 80% accuracy a cancer that decimated the MALE population, it would be recommended for the general MALE population immediately. False positives or not.

    This makes me livid.

    December 12, 2010 at 22:48 | Report abuse | Reply
    • rh

      Nah, but if it gave them an er*ction and had a risk of permanently blinding men, it would be available and covered by insurance...

      December 13, 2010 at 00:30 | Report abuse |
    • Rob

      Right – because there's no controversy over prostate CA screening or anything like that...

      December 13, 2010 at 11:17 | Report abuse |
    • Fiona

      Rob, any controversy that exists over prostate screening has to do with the VERY slow progress of that disease. It is thought by some that a man over a certain age who screens positive for prostate cancer will be more adversely affected by the surgery than by letting the cancer progress. That is, he will likely die of old age or other health problems before his prostate cancer develops into a problem. Uterine cancer progresses quickly, and kills. And up until now it has been very hard to diagnose early enough to help the patient.

      December 13, 2010 at 12:46 | Report abuse |
    • Rob

      Agree 100% Fiona. My point wasn't to compare the disease process of endometrial v prostate CA per se, but rather the notion proposed in the original statement that the controversy with endometrial CA screening is somehow related to poorer decision-making for a woman's disease, as compared to a male's disease. This notion is silly. Look at the progress with cerivcal CA screening with PAPs and now even a vaccine...

      Prostate CA is certainly a chronic disease unlike other Cancers, and screening for such is obviouisly controversial for good reason (and much different reason that endometrial CA as you point out). Nonetheless, my point is that contreversy exists for both male and female disorders.

      I think this article points out nicely that before we jump to a new screening test, we need to make sure we weigh pro/cons carefully. The article implies that the specficity (not sensitivity) of the test isn't perfect, and that false positives carry have the potential to carry significant burden to the patient. This may be "worth it" if more endometrial CAs are caught early; however, the article points out that we probably don't have this info yet.

      December 13, 2010 at 15:47 | Report abuse |
  4. Fiona

    So all cancers are caused by a common STD? Right. So genetic factors, UV rays, carcinogen exposure, radiation, viruses...do not cause cancer. I guess Moniistat cream is the cure for what ails us, then. gee, if i'd only known, I wouldn't have lost family members to colon cancer, ovarian cancer, melanoma, leukemia, bone cancer, uterine cancer. All they needed was a fungal cream and prayer. Darn.

    December 12, 2010 at 22:54 | Report abuse | Reply
  5. Ashley

    Seriously? Jose, slap yourself. Twice.

    December 12, 2010 at 22:57 | Report abuse | Reply
  6. Pat Fox

    Jose, you should be ashamed of yourself for promoting quackery that might dissuade cancer patients from seeking actual treatments that can cure and save lives and suffering. Candida causes illnesses like thrush and other forms of candidiasis, but it is most certainly not the cause of cancer. This is junk "science" and mostly fraud designed to separate people from their money but not their disease. Anyone who had or thinks they might have cancer should seek help from a qualified oncologist, not some loon on the internet.

    December 13, 2010 at 00:54 | Report abuse | Reply
  7. Maria

    As a female with Lynch Syndrome, I want to encourage women under the age of 50 who are diagnosed with either colon or uterine to get tested for the other one too. I was diagnosed with both of them within six months of each other at the age of 43. They were two separate distinct cancers...one was not spread from the other. My uterine lining was abnormally thick, which led the doctor to do a biopsy. This biopsy came back negative, even though a D & C the following month caught the cancer. Biopsies are a good tool, but they're not always perfect.

    December 13, 2010 at 09:21 | Report abuse | Reply
    • OH's Mama

      Maria, thanks for the advice. It is always good to hear the thoughts from someone who has "been there, done that.". I hope you are doing well now.

      December 13, 2010 at 10:24 | Report abuse |
  8. Wzrd1

    That happens to be the funniest bit of quackery I've EVER heard!
    First, candida albicans is a yeast. It's living happily inside the gut and mouth of nearly every human alive.
    Second, sodium bicarbonate is beyond harmless to that yeast. It would be like giving it a nice, warm shower.
    So, you and your "wise" leader should move on to newer and better quackery, this was the dumbest thing I've heard since having people being bled for influenza.

    December 13, 2010 at 10:44 | Report abuse | Reply
  9. razzlea

    interesting, Check out my health and fitness blog http://razzlea.blogspot.com/

    December 13, 2010 at 11:00 | Report abuse | Reply
    • notmyrealname

      Nah. If it were any good, you wouldn't have to spam it.

      December 13, 2010 at 22:37 | Report abuse |
  10. Fiona

    And now most of these comments make no sense because Jose el Loco's post is deleted and the replies became original posts. For anyone reading this: Jose opined that all cancer was caused by candida albicans.

    December 13, 2010 at 12:39 | Report abuse | Reply
    • JC-VA

      Thank You, I was wondering about that Jose myself...

      December 13, 2010 at 15:56 | Report abuse |
    • Paige

      Although I don't know exactly what Jose posted, I do know that I have Candidas Albicans and I just read something that led me to this site because I think I might have uterine cancer. First off, Candidas Albicans is NOT an STD, please educate yourself. Also, Candidas Albicans can wreak havok on your system when out of control, I know because it has on mine already.It is very hard to get the bad bacteria under control and the good bacteria back in your system. I'm finally beginning to fight this Candidas and I now suspect I have uterine cancer....please educate yourself and take Candidas Albicans seriously because I don't think I took it seriously enough:( God Bless!

      April 7, 2012 at 04:18 | Report abuse |
  11. DenverGrl

    My mother died of uterine cancer in April, 2009. She was asymptomatic until she started bleeding (post menopause). By the time she got to the doctor, it had already spread to one lymph node. They did a radical hysterectomy and got the cancer out, but the one lymph node carried it to her brain. 1.5 years later she died after a slow and painful fight against the cancer in her brain. Of the 1.5 years she survived after the hysterectomy, she had about 5-6 months of good quality life before the cancer robbed her of personality and ability to do just about anything for herself. At 33, it was one of the most devastating experiences of my life. Please, please, please, I beg you, get yourself checked every year, more often if uterine cancer runs in your family. Save yourself and your family a lot of misery.

    December 13, 2010 at 15:34 | Report abuse | Reply
  12. Gricelda Stewarts

    Uterine cancer usually occurs after menopause. Being obese and taking estrogen-alone hormone replacement therapy (also called menopausal hormone therapy) also increase your risk. Treatment varies depending on your overall health, how advanced the cancer is and whether hormones affect its growth. Treatment is usually a hysterectomy, which is surgery to remove the uterus. The ovaries and fallopian tubes are also removed. Other options include hormone therapy and radiation. *,:*

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    July 6, 2013 at 23:03 | Report abuse | Reply
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