TY - JOUR
T1 - Capacity of endometrial thickness measurement to diagnose endometrial carcinoma in asymptomatic postmenopausal women: a systematic review and meta-analysis
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
Y1 - 2012
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 x 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, 2.63.3 mm). The pooled estimated prevalences of endometrial carcinoma and atypical endometrial hyperplasia were 0.62% (95% CI, 0.420.82%) and 0.59% (95% CI, 0.220.96%), respectively. Summary estimates for sensitivity and specificity of TVS endometrial thickness measurement in the prediction of endometrial carcinoma were 0.83 (95% CI, 0.191.00) and 0.72 (95% CI, 0.230.95) for a 5-mm cut-off and 0.33 (95% CI, 0.040.85) and 0.94 (95% CI, 0.920.96) 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. Copyright (C) 2012 ISUOG. Published by John Wiley & Sons, Ltd
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 x 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, 2.63.3 mm). The pooled estimated prevalences of endometrial carcinoma and atypical endometrial hyperplasia were 0.62% (95% CI, 0.420.82%) and 0.59% (95% CI, 0.220.96%), respectively. Summary estimates for sensitivity and specificity of TVS endometrial thickness measurement in the prediction of endometrial carcinoma were 0.83 (95% CI, 0.191.00) and 0.72 (95% CI, 0.230.95) for a 5-mm cut-off and 0.33 (95% CI, 0.040.85) and 0.94 (95% CI, 0.920.96) 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. Copyright (C) 2012 ISUOG. Published by John Wiley & Sons, Ltd
U2 - https://doi.org/10.1002/uog.12306
DO - https://doi.org/10.1002/uog.12306
M3 - Review article
C2 - 23001905
SN - 0960-7692
VL - 40
SP - 621
EP - 629
JO - Ultrasound in Obstetrics & Gynecology
JF - Ultrasound in Obstetrics & Gynecology
IS - 6
ER -