Summary of Evidence

Transvaginal Ultrasound
        Benefits
        Harms
Endometrial Sampling (Biopsy)
        Benefits
        Harms

Separate PDQ summaries on Endometrial Cancer Prevention; Endometrial Cancer Treatment; and Uterine Sarcoma Treatment are also available.

There is no evidence that screening by ultrasonography (e.g., endovaginal ultrasound or transvaginal ultrasound) reduces mortality from endometrial cancer. Most cases of endometrial cancer (85%) are diagnosed at low stage because of symptoms, and survival rates are high.

Based on solid evidence, screening asymptomatic women will result in unnecessary additional biopsies because of false-positive test results. Risks associated with false-positive tests include anxiety and complications from biopsies.

• Study Design: Evidence obtained from cohort studies.
• Internal Validity: Fair.
• Consistency: One study for endometrial biopsy and one study for hysteroscopy.
• Magnitude of Effects on Health Outcomes: Small negative magnitude.
• External Validity: Fair.

There is inadequate evidence that screening by endometrial sampling (i.e., biopsy) reduces mortality from endometrial cancer. Most cases of endometrial cancer (85%) are diagnosed at low stage because of symptoms, and survival rates are high.

Based on solid evidence, endometrial biopsy may result in discomfort, bleeding, infection, and rarely, uterine perforation.

• Study Design: Evidence obtained from cohort studies.
• Internal Validity: Fair.
• Consistency: One study for endometrial biopsy and one study for hysteroscopy.
• Magnitude of Effects on Health Outcomes: Small negative magnitude.
• External Validity: Fair.