What is endometrial cancer screening ?
There is no widespread screening for women who do not have symptoms and are not considered at risk. However, regular gynecological exams, even in the absence of symptoms, contribute to the early detection of endometrial cancer.
In fact, one of the best ways to detect endometrial cancer early is to educate women to remain vigilant and consult their gynecologist if they experience abnormal vaginal bleeding.
For women experiencing vaginal bleeding after menopause (metrorrhagia), measuring endometrial thickness via transvaginal ultrasound is an excellent method to determine whether further investigations are necessary to identify potential cancerous lesions.
Transvaginal ultrasound
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Transvaginal ultrasound is a non-invasive technique that uses ultrasound to create images of the uterus. A probe inserted into the vagina emits sound waves that bounce off the tissues of the internal reproductive organs. The echoes are analyzed by a device that generates images displayed on a screen. These images allow for the measurement of the uterus size, the thickness of the endometrium, and help in identifying the presence of a tumor.
For women at risk, particularly those treated with tamoxifen or those on hormone replacement therapy (HRT) with estrogen, an ultrasound may be recommended to measure endometrial thickness. In some cases, a biopsy, involving the collection of a small sample of the endometrium, may also be prescribed.
Endometrial biopsy
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Two techniques are used to perform an endometrial biopsy.
The first involves aspiration biopsy: a thin tube ( catheter ) is inserted into the uterus through the cervix to collect a small sample of endometrial tissue by suction. This technique can detect most endometrial cancers.
The second technique involves performing a biopsy curettage , which requires prior cervical dilation using a laminaria stick (a highly dehydrated rod derived from the Laminaria digitata seaweed). Once inserted into the cervix, the laminaria expands as it absorbs moisture, dilating the cervix. Endometrial fragments are then collected by curettage using an instrument called a curette , which scrapes the endometrium. The tissue samples collected during the biopsy are examined under a microscope by an anatomical pathologist , a physician specializing in the study of organs, tissues, and cells.
For patients with Lynch syndrome, annual gynecological monitoring is recommended. Additionally, an endometrial biopsy should be performed every year starting at age 35 (source: arcagy.org).
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Article updated on Jan 23, 2025
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