Accuracy of Transvaginal Ultrasonography in Prediction of Endometrial Pathology in Post Menopausal Women

INTRODUCTION: Health aspects in postmenopausal women have gained importance in recent years owing to the increased life expectancy. According to WHO, the disability adjusted life expectancy (DALE) exceeds 70 yrs in about 24 countries, with women living longer than men by an average of 7 to 8 years. The average age at menopause ranges from 45 yrs in the Indian woman to 51 years in the Western population depending on the hereditary, life style and nutritional factors. Thus a woman spends more than two to three decades of life in her menopause. The principal gynecological cancers (breast, ovary, uterus, and cervix) account for over 40% of cancers found in women worldwide. However, large differences exist, in both their incidence and geographical distribution. Endometrial cancer is currently the most common gynecological malignancy in developed countries. A number of reports have suggested that the incidence of carcinoma of the endometrium is increasing in the United States and other industrialised countries. The incidence of endometrial cancer is 3.7% to 17.9% in postmenopausal women with abnormal uterine bleeding. The incidence of endometrial cancer in asymptomatic women was 0.13% and atypia was seen in 0.63%. Endometrial carcinoma fortunately when detected early can be cured with less morbidity and mortality. It has much higher cure rates if diagnosed early. Localised disease (stage I and II) has a 5 year survival of 87% and 76% respectively, but much poorer for stage III with 5 yr survival rate of