Patient acceptance of transvaginal sonographic endometrial thickness assessment compared with hysteroscopy and biopsy for exclusion of endometrial cancer in cases of postmenopausal bleeding.

Autor:	Fung LWY; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong., Cheung ECW; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong., Wong ASW; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong., Sahota DS; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong., Lao TTH; Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong.
Jazyk:	angličtina
Zdroj:	Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2022 Apr; Vol. 28 (2), pp. 133-139. Date of Electronic Publication: 2022 Apr 12.
DOI:	10.12809/hkmj208792
Abstrakt:	Introduction: Available examinations for women with postmenopausal bleeding include transvaginal sonography to measure endometrial thickness (TVS-ET), and invasive endometrial assessment using hysteroscopy/endometrial biopsy. However, selection of the examination method seldom involves consideration of patient preferences. The aim of this study was to examine patient preferences for the method used to investigate postmenopausal bleeding. Methods: Women were asked to complete an interviewer-administered structured survey before they underwent clinical investigations at a university gynaecology unit from June 2016 to June 2017. Using the standard gamble approach, women were asked to choose between invasive assessment by hysteroscopy/endometrial biopsy (gold standard) or TVS-ET with a risk of missing endometrial cancer. The risk of missing endometrial cancer during TVS-ET was varied until each woman was indifferent to either option. Results: The median detection rate for endometrial cancer required using TVS-ET was 95% (interquartile range=80%-99.9%). In total, 200 women completed the survey, and 77 (38.5%) women required TVS-ET to have a 99.9% detection rate for endometrial cancer. Prior hysteroscopy experience was the only factor that influenced the women's decisions: a significantly higher detection rate was required by this patient group than by patients without previous hysteroscopy experience (P=0.047). Conclusion: A substantial proportion of women would accept TVS-ET alone for the investigation of postmenopausal bleeding. In the era of patientcentred care, clinicians should incorporate patient preferences and enable women to make informed choices concerning the management of postmenopausal bleeding. Competing Interests: All authors have disclosed no conflicts of interest.
Databáze:	MEDLINE
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