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Good Positive and Negative Likelihood Ratios

Good Negative Likelihood Ratio

Good Positive Likelihood Ratio

Poorly Diagnostic Findings

Endometrial Cancer: Likelihood Ratios

Introduction: Adenocarcinoma of the endometrium occurs generally in 2 types, with type I being the most common, hormone-sensitive, and having a better prognosis. Overall, ~70% of patients present in Stage I because of abnormal uterine bleeding.

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Tags: Gynecologic Neoplasm Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Postmenopausal Women with Abnormal Uterine Bleeding 12% "5-20%". From UpToDate (http://www.utdol.com/online/content/topic.do?topicKey=gyne_onc/9015)
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The likelihood ratios of findings for Endometrial Cancer are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding +LR-LR Comments, Study
Endometrial Biopsy Edit 49.80

In postmenopausal women. Using the Pipelle device, which has been shown to be the best. Sensitivity in premenopausal women is lower at 91%.

Study: Cancer 2000 Oct 15;89(8):1765-72. PMID 11042572

Trans-Vaginal Ultrasound
Duplicate Edit
7.30.1

Study: no study specified.

Trans-Vaginal Ultrasound
Duplicate Edit
20.1

Endometrial thickness >4mm. As thickness increases (especially >15-20mm) the likelihood of cancer increases. (Note that this is in postmenopausal women).

Study: Acta Obstet Gynecol Scand 2002 Sep;81(9):799-816. PMID 12225294

Good Negative Likelihood Ratio

Finding +LR-LR Comments, Study
Postmenopausal Edit 1.20.4

Study: Gynecol Oncol. 1995 Mar;56(3):376-81 PMID: 7705671

Good Positive Likelihood Ratio

Finding +LR-LR Comments, Study
Age Edit 8.20.8

>=70 years, in patients with abnormal vaginal bleeding

Study: Gynecol Oncol. 1995 Mar;56(3):376-81 PMID: 7705671

History of Estrogen Use Edit 3.90.9

Study: Gynecol Oncol. 1995 Mar;56(3):376-81 PMID: 7705671

Diabetes Edit 2.60.9

Study: Gynecol Oncol. 1995 Mar;56(3):376-81 PMID: 7705671

Nulliparity Edit 2.30.8

Study: Gynecol Oncol. 1995 Mar;56(3):376-81 PMID: 7705671

Poorly Diagnostic Findings

Finding +LR-LR Comments, Study
Vaginal Bleeding Edit Sensitivity = 90%

i.e. abnormal uterine bleeding

Study: UpToDate http://www.utdol.com./online/content/topic.do?topicKey=gyne_onc/9015

Dilatation and Curettage Edit Sensitivity = 89%

Hysteroscopically guided biopsies had greater sensitivity.

Study: Acta Obstet Gynecol Scand 2001 Dec;80(12):1131-6. PMID 11846711

ThinPrep Pap Smear Edit Sensitivity = 65%

Specificity, stage not specified. Sensitivity of traditional Pap smear was 39% in this study.

Study: Cancer. 2002 Dec 25;96(6):338-43. PMID 12478681

Hysteroscopy Edit Sensitivity = 65%

Alone, without biopsies.

Study: UpToDate article does not specify a reference for this study.

http://www.utdol.com/online/content/topic.do?topicKey=gen_gyne/27128

Traditional Pap Smear Edit Sensitivity = 48%

For Stage I. No specificity provided. Sensitivity increases to 86% for stages II+.

Study: Acta Cytol. 2001 Jul-Aug;45(4):555-60. PMID 11480718