Endometrial thickness evaluation with ultrasonography assessment among normal and endometrial cancer across multi-ethnic Indonesian women.

Abstract

Introduction: Endometrial thickness is a crucial indicator for reproductive health evaluation and initial detection of abnormalities. This study aims to comprehensively characterize and evaluate the endometrium in normal and cancer of Indonesian women using ultrasonography.

Methods: This retrospective investigation analyzed ultrasound data from three hospitals during 2021-2024 in women who met predefined inclusion criteria. Subjects were classified according to age, ethnicity, menopausal status, and ultrasound-based examination category.

Results and discussion: Endometrial thickness was quantified in 170 women with normal gynecological result and 82 women with histopathologically confirmed endometrial cancer. The average age of the normal group was 40.63 ± 0.91 years while the cancer group had an average age of 52.28 ± 1.33 years, significantly indicating that cancer subjects were generally of greater age. Endometrial thickness significantly decreased with advancing age, with the reduces values in women over 50 years (post-menopausal). There was a significant difference in endometrial thickness between normal and cancer cases, with optimal diagnostic cut-off values of 12.85 mm (AUC 0.89, sensitivity 0.83, specificity 0.94) for women aged ≤50 years and 10.20 mm (AUC 0.99, sensitivity 0.97, specificity 1.00) for women aged >50 years. These results underscore the robust relationship between age, menopausal status, and endometrial pathology, and support the clinical utility of ultrasound as a non-invasive method for early detection and risk profiling of endometrial abnormalities.