Objective: To review the evidence relating to the epidemiology of endometrial cancer and its diagnostic workups.
Options: Women with possible endometrial cancer can undergo an endometrial evaluation by office biopsy, hysteroscopy, or dilatation and curettage. To assist in treatment planning, pelvic ultrasound, CT scan, or MRI may be considered.
Outcomes: The identification of optimal diagnostic tests to evaluate patients with possible endometrial cancer.
Evidence: Published literature was retrieved through searches of PubMed, CINAHL, and The Cochrane Library, using appropriate controlled vocabulary (e.g., endometrial neoplasms) and key words (e.g., endometrium cancer, endometrial carcinoma). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 31, 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, national and international medical specialty societies, and recent conference abstracts.
Values: The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table).
Benefits, harms, and costs: This document is intended to guide the development of a standardized cost-effective investigation of patients with suspected endometrial cancer.
Validation: The guideline was reviewed for accuracy by experts in pathology, radiation oncology, and medical oncology. Guideline content was also compared with relevant documents from the American Congress of Obstetricians and Gynecologists.
Keywords: MRI; diagnostic workup; endometrial cancer; endometrial evaluation; magnetic resonance imaging; postmenopausal bleeding; ultrasound.