A FEASIBILITY STUDY OF SCREENING FOR ENDOMETRIAL CARCINOMA IN POSTMENOPAUSAL WOMEN BY ULTRASONOGRAPHY

Background Abnormal endometrial thickness assessed by ultrasonography has been reported as a reliable indicator for early asymptomatic endom etrial carcinoma. Study design: We evaluated the feasibility and the p erformance of screening by ultrasonography in a consecutive series of postmenopausal volunteers. Results: A total of 2,025 women were screen ed, and 117 (5.8%) showed abnormal endometrial thickness, Ninety-eight subjects consented to be assessed by outpatient endometrial biopsy, w hich was not possible in 32 for cervical stenosis. Three cancers were detected among 66 assessed subjects, 34 not-assessed subjects were con trolled by repeat sonography (no change), and 17 were lost to follow-u p. No other cancer was recorded by the local Cancer Registry among scr eened subjects. The prevalence/incidence ratio was 2.65:1, and the cos t per screen-detected cancer was 18,571,000 Italian lire. Conclusions: Screening by endometrial sonography is feasible on a practical basis, but its efficacy needs to be proven by prospective controlled studies which would enroll large populations to ensure sufficient statistical power, considering the low incidence and the low lethality of the dis ease. Studies of screening for other carcinomas may be considered of h igher priority.