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Endometrial cancer risk — MCCQE Part 1 MCQ

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ModerateAbnormal Vaginal BleedingEndometrial cancer riskMCCQE Part 1

A 57-year-old woman presents with two episodes of postmenopausal bleeding. She has obesity and hypertension and has not used hormone therapy. Pelvic examination is normal. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Endometrial biopsy or transvaginal ultrasound assessment of endometrium

Postmenopausal bleeding requires evaluation for endometrial cancer, commonly with endometrial biopsy and/or transvaginal ultrasound depending on local pathway. Reassurance is inappropriate even when bleeding is intermittent. CA-125 is not the initial test for postmenopausal bleeding.

Reference: SOGC abnormal uterine bleeding guidance