Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;32(10):1104-1110.
doi: 10.1089/jwh.2022.0534. Epub 2023 Aug 1.

Endometrial Cancer Knowledge and Guideline-Concordant Practice Patterns Among First-Line Providers

Liz Sage  1 , Erin Dwyer  1 , Dorender A Gray  1 , Ann Oluloro  1 , Patrice A Williams  1 , Ronit Katz  1 , Noah J Qualls  1 , Kemi M Doll  1
Affiliations

Endometrial Cancer Knowledge and Guideline-Concordant Practice Patterns Among First-Line Providers

Liz Sage et al. J Womens Health (Larchmt). 2023 Oct.

Abstract

Background: Provider uncertainty about the appropriate guideline-concordant evaluation of endometrial cancer (EC) symptoms may be a factor in racial inequities in EC. To evaluate the relationship between EC knowledge and reported practice patterns in a nationally representative survey of first-line providers for initial EC symptoms. Materials and Methods: This was a mailed cross-sectional survey of physicians and nurse practitioners from professional organization roster of providers from Obstetrics and Gynecology (OBGYN), Family Medicine, Internal Medicine, and Emergency Medicine. It queried demographics, practice characteristics, EC knowledge, and guideline-concordant practice patterns via three case vignettes. Regions of low response were retargeted to ensure strong representation among providers caring for Black women patients. EC knowledge was analyzed via a composite score (range: -3 to 10, with higher scores representing more EC knowledge), and adjusted prevalence ratios (PRs) used to test the association between knowledge and reported practice patterns. Results: Among 531 returned surveys (response rate = 38%), OBGYN had highest (53%) frequency of >6 (median) EC knowledge score, and Emergency Medicine had the lowest (15%) (p < 0.001). Nonguideline-concordant practice patterns were reported in 14%, 41%, and 35% of the three EC cases presented. Providers with knowledge >6, (n = 205) were significantly more likely to report guideline-concordant care on case vignettes (PR 1.28-1.36). Conclusions: In a national survey of multi-specialty backgrounds, there were basic knowledge gaps about EC and EC risk factors among providers, and a sizeable proportion reported nonguideline concordant practices. These findings indicate the importance of targeted education and training for first-line providers, as EC incidence rises.

Keywords: clinical guidelines; endometrial biopsy; endometrial cancer; gynecologic cancer; health care provider; health inequities.

PubMed Disclaimer

References

    1. National Cancer Institute. Uterine Cancer—Cancer Stat Facts. 2018. Available from: https://seer.cancer.gov/statfacts/html/corp.html [Last accessed: April 7, 2023].
    1. Lortet-Tieulent J, Ferlay J, Bray F, et al. . International patterns and trends in endometrial cancer incidence, 1978–2013. J Natl Cancer Inst 2018;110(4):354–361; doi: 10.1093/jnci/djx214 - DOI - PubMed
    1. Rodriguez VE, LeBrón AMW, Chang J, et al. . Guideline-adherent treatment, sociodemographic disparities, and cause-specific survival for endometrial carcinomas. Cancer 2021;127(14):2423–2431; doi: 10.1002/cncr.33502 - DOI - PMC - PubMed
    1. Doll KM, Hempstead B, Alson J, et al. . Assessment of prediagnostic experiences of Black women with endometrial cancer in the United States. JAMA Netw Open 2020;3(5):e204954; doi: 10.1001/jamanetworkopen.2020.4954 - DOI - PMC - PubMed
    1. Romano SS, Doll KM. The impact of fibroids and histologic subtype on the performance of US clinical guidelines for the diagnosis of endometrial cancer among Black women. Ethn Dis 2020;30(4):543–552; doi: 10.18865/ed.30.4.543 - DOI - PMC - PubMed

Publication types

LinkOut - more resources