Gynecologic oncology reports · 2026
Barriers to the recognition and evaluation of abnormal uterine bleeding among individuals at increased risk for endometrial Cancer.
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Harrington Shariska P, Taheri Negar, Salinas Manisha, Mehltretter Andilyn, McConnell Nicholas, O'Neill Martha, Agarwal Arushi, Hochberg Donna, Beer Tomasz, Camardo Mark, Kielar-Grevstad Elle, Bakkum-Gamez Jamie N
Аннотация
OBJECTIVE: To evaluate knowledge of abnormal uterine bleeding (AUB) and postmenopausal bleeding (PMB) as symptoms of endometrial cancer (EC), assess understanding of diagnostic evaluation, and identify barriers and facilitators to care.
METHODS: We conducted a web-based survey of participants (N = 603) with a history of AUB/PMB and increased risk for EC. The survey, informed by semi-structured interviews, assessed symptom recognition, knowledge of EC, familiarity with diagnostic evaluation, and healthcare-seeking behaviors. Descriptive statistics, chi-square tests, and multivariable logistic regression evaluated associations between demographic, clinical factors and study outcomes.
RESULTS: Although 78% recognized abnormal bleeding within six months, 21% reported delayed recognition and 25% had not sought evaluation. Only 12% identified AUB/PMB as a potential symptom of cancer, with participants aged ≥45 years less likely to make this association. While 75% sought medical care, 28% reported that their healthcare provider was not concerned about their bleeding; among these participants, 60% reported experiencing symptom dismissal. Familiarity with endometrial biopsy was lower among Medicaid-insured participants (OR 0.50, 95% CI 0.33-0.77). More convenient testing options increased self-reported motivation to seek evaluation.
CONCLUSIONS: Knowledge gaps, delayed symptom recognition, and experiences of symptom dismissal identify potential barriers along the pathway to evaluation of abnormal bleeding.
METHODS: We conducted a web-based survey of participants (N = 603) with a history of AUB/PMB and increased risk for EC. The survey, informed by semi-structured interviews, assessed symptom recognition, knowledge of EC, familiarity with diagnostic evaluation, and healthcare-seeking behaviors. Descriptive statistics, chi-square tests, and multivariable logistic regression evaluated associations between demographic, clinical factors and study outcomes.
RESULTS: Although 78% recognized abnormal bleeding within six months, 21% reported delayed recognition and 25% had not sought evaluation. Only 12% identified AUB/PMB as a potential symptom of cancer, with participants aged ≥45 years less likely to make this association. While 75% sought medical care, 28% reported that their healthcare provider was not concerned about their bleeding; among these participants, 60% reported experiencing symptom dismissal. Familiarity with endometrial biopsy was lower among Medicaid-insured participants (OR 0.50, 95% CI 0.33-0.77). More convenient testing options increased self-reported motivation to seek evaluation.
CONCLUSIONS: Knowledge gaps, delayed symptom recognition, and experiences of symptom dismissal identify potential barriers along the pathway to evaluation of abnormal bleeding.