Summary of Evidence
Separate PDQ summaries on Endometrial Cancer Prevention; Endometrial Cancer Treatment; and Uterine Sarcoma Treatment are also available.
Understanding Cervical Cancer -- Treatment
Every woman should have a regular pelvic exam and Pap test, which tests a cervical cell sample for abnormalities. Together, these procedures detect cervical cancer 95% of the time, often long before the disease produces symptoms. If your Pap test is abnormal, your doctor may test you again. Recently, some doctors have started to test for HPV at the time of Pap smear. If a high-risk type of HPV is found in women with an abnormal Pap test, doctors are more inclined to do a colposcopy (magnified exam...
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Benefits
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.
Harms
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.
Endometrial Sampling (Biopsy)
Benefits
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.
Harms
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.
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