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Endometrial cancer — DRCOG MCQ

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HardGynaecological OncologyEndometrial cancerDRCOG

A 58-year-old has new unexplained watery vaginal discharge and visible haematuria. She has no postmenopausal bleeding and examination is unremarkable. What is the most appropriate primary-care action?

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Correct answer: E — Urgent direct-access ultrasound to assess endometrial pathology

The best answer is “Urgent direct-access ultrasound to assess endometrial pathology”. For people aged 55 or over, NICE advises considering urgent direct-access ultrasound to assess for endometrial cancer when unexplained vaginal discharge is accompanied by haematuria. This is a distinct investigation pathway; cervical screening and empirical treatment do not assess the endometrium.

Reference: NICE NG12: Suspected cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/recommendations-organised-by-site-of-cancer