Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women: A systematic review and meta-analysis

M. C. Breijer, J. A H Peeters, B. C. Opmeer, T. J. Clark, R. H M Verheijen, B. W J Mol, A. Timmermans

Research output: Contribution to journalReview article

46 Citations (Scopus)

Abstract

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 11 100 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.

LanguageEnglish
Pages621-629
Number of pages9
JournalUltrasound in Obstetrics and Gynecology
Volume40
Issue number6
DOIs
Publication statusPublished - Dec 2012

Keywords

  • asymptomatic postmenopausal women
  • atypical hyperplasia
  • endometrial carcinoma
  • endometrial thickness
  • meta-analysis

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Medicine(all)

Cite this

Breijer, M. C. ; Peeters, J. A H ; Opmeer, B. C. ; Clark, T. J. ; Verheijen, R. H M ; Mol, B. W J ; Timmermans, A. / Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women : A systematic review and meta-analysis. In: Ultrasound in Obstetrics and Gynecology. 2012 ; Vol. 40, No. 6. pp. 621-629.
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abstract = "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 11 100 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.",
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Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women : A systematic review and meta-analysis. / Breijer, M. C.; Peeters, J. A H; Opmeer, B. C.; Clark, T. J.; Verheijen, R. H M; Mol, B. W J; Timmermans, A.

In: Ultrasound in Obstetrics and Gynecology, Vol. 40, No. 6, 12.2012, p. 621-629.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women

T2 - Ultrasound in Obstetrics and Gynecology

AU - Breijer, M. C.

AU - Peeters, J. A H

AU - Opmeer, B. C.

AU - Clark, T. J.

AU - Verheijen, R. H M

AU - Mol, B. W J

AU - Timmermans, A.

PY - 2012/12

Y1 - 2012/12

N2 - 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 11 100 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.

AB - 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 11 100 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.

KW - asymptomatic postmenopausal women

KW - atypical hyperplasia

KW - endometrial carcinoma

KW - endometrial thickness

KW - meta-analysis

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