OC21.05: Assessing racial disparities in sonographic detection of endometrial cancer

Compare the efficacy of transvaginal sonogram (TVS), sonohysterogram (SIS) and endometrial aspiration (EA), in detecting endometrial cancer or hyperplasia (ECH) between black and non-black women. Prospective study of 1840 women > 50 years who underwent endometrial evaluation between 2/2014-10/2019. All cases with known ethnicity and clinical outcomes were included. Method completion was defined as the ability to measure the endometrium for TVS/SIS or to obtain tissue for EA. For high-risk screening we used endometrial thickness (ET) >4mm for TVS; ET >5mm and/or focal lesion for SIS and pathology consistent with ECH for EA. The analysis focused on the ability to complete procedures and their performance in ECH detection, comparing sensitivity, specificity, and predictive values across racial groups. Total of 1,840 women (average age 60.4 years, mean BMI 33.2), with racial distribution as follows: 833 (45.2%) black, (38.6%) Hispanic, 253(13.7%) White, and 43 (2.3%) other groups. ECH rate was 9.4%. Black women had higher BMI, fibroid presence and uterine volume (all P < 0.001). TVS completion rates were significantly lower in black women compared to non-black women (75.8% vs. 86.5%, p < 0.001), with fibroids negatively impacting the likelihood of completion (RR 0.84, 95% CI 0.77,0.91) (see table 1). The detection rates of ECH of completed TVS and SIS procedures showed no significant racial disparities (see table 2). TVS, SIS and EA performance for ECH detection was similar between racial groups. TVS completion rate was less in black than non-black women, with fibroids negatively impacting the likelihood of completion. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.