What are the guidelines for endometrial cancer screening?

From the Guidelines

Endometrial cancer screening is not recommended for women at average risk, but those at high risk due to genetic mutations, such as Lynch syndrome, should consider annual testing starting at age 35.

Guidelines for Endometrial Cancer Screening

• Women at average risk should be informed about the risks and symptoms of endometrial cancer, particularly unexpected bleeding and spotting, and report these symptoms to a clinician immediately 1.
• Women at high risk due to genetic mutations, such as Lynch syndrome, should consider annual testing for early endometrial cancer detection starting at age 35 1.
• The evaluation of endometrial histology with an endometrial biopsy is the standard for determining the status of the endometrium 1.
• Women with Lynch syndrome should be informed about the potential benefits, risks, and limitations of testing for early endometrial cancer detection, and consider options such as annual screening, regular hysteroscopy and endometrial biopsies, or prophylactic hysterectomy and bilateral salpingo-oophorectomy 1.
• Universal screening for Lynch syndrome in endometrial cancer is recommended where resources are available, and targeted screening is recommended where resources are restricted 1.

From the Research

Guidelines for Endometrial Cancer Screening

• The American Cancer Society recommends that all women older than 65 years be informed of the risks and symptoms of endometrial cancer and advised to seek evaluation if symptoms occur 2.
• There is no evidence to support endometrial cancer screening in asymptomatic women 2, 3.
• Screening in high-risk populations, such as those with Lynch syndrome, is recommended 4.
• For women with Lynch syndrome, combined colonoscopy and endometrial biopsy cancer screening is feasible and can provide a less painful and more satisfactory experience 4.

Screening Methods

• Transvaginal ultrasonography or endometrial biopsy are recommended as the initial study for evaluating suspected endometrial cancer 2.
• Measurement of the endometrial thickness by transvaginosonography (TVS) can define a risk group for endometrial cancer in postmenopausal women 5.
• A serum metabolomic signature has been developed and validated for endometrial cancer screening in postmenopausal women, with an accuracy of greater than 99% 6.

High-Risk Populations

• Women with Lynch syndrome are at increased risk of endometrial cancer and should undergo regular screening 4.
• Other high-risk populations, such as those with a family history of endometrial cancer or certain genetic mutations, may also benefit from regular screening 2.