Transvaginal ultrasonography of the endometrium in postmenopausal Japanese women.
OBJECTIVE
To determine the cut-off level of endometrial thickness for detecting endometrial disease on a large scale of screening and to examine the usefulness of transvaginal ultrasonography (TVS) for endometrial disease screening in asymptomatic postmenopausal Japanese women.


METHODS
The study involved 1,400 postmenopausal women in whom endometrial thickness was measured with TVS, and then compared with the histopathological diagnosis of endometrial specimens.


RESULTS
The prevalence of endometrial disease in asymptomatic and symptomatic cases was 2.3 and 21%. In symptomatic cases, at a cut-off limit of 3 mm for endometrial thickness, the sensitivity for detecting endometrial disease was 94%, specificity 70% and positive predictive value 46%. With an endometrial thickness < or = 3 mm, the probability that endometrial disease would be overlooked was 0.025. In asymptomatic cases, the corresponding figures at a cut-off limit of 3 mm were 90, 84, 12% and 0.003.


CONCLUSIONS
TVS does not appear to be an effective screening method in asymptomatic postmenopausal Japanese women because of the low prevalence of endometrial disease in this population. We recommend a normal cut-off level for endometrial thickness of 4 mm in symptomatic postmenopausal Japanese women.
Tsuda
Hiroshi
H
Department of Obstetrics and Gynecology, Osaka City General Hospital, Osaka, Japan. htsud@s5.dion.ne.jp
Nakamura
Hiroaki
H
Inoue
Takeshi
T
Kawamura
Naoki
N
Adachi
Ken-ichi
K
Bandera
Christina A
CA
D000328:Adult; D000368:Aged; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology