WASHINGTON, DC (October 13, 2025)—Abnormal uterine bleeding (AUB) can be a symptom of uterine cancer, so it’s important for patients who have it to receive appropriate evaluation. Although AUB is a common gynecologic condition that can have many different causes, approximately 90% of those with uterine cancer have AUB. In a study selected as the Editor’s Choice for the September/October Women’s Health Issues, the authors examined the care of non-pregnant Black, Hispanic, and white women who visited emergency departments because of AUB.
Women’s Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based at the Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
Wanyi Huang, MPH, of Yale School of Medicine, and colleagues used 2014-2021 National Hospital Ambulatory Medical Care Survey data to identify non-Hispanic Black, non-Hispanic white, and Hispanic patients who visited emergency departments for non-pregnancy-related AUB. They investigated the likelihood of patients from these groups a) obtaining the first-line imaging evaluation of transvaginal ultrasound or an order for it and b) receiving recommendations or referrals for follow-up consultation. While they did not find significant differences between non-Hispanic white and Hispanic patients on these outcomes, they did find that non-Hispanic Black patients were less likely than non-Hispanic white patients to have received either of these recommended actions. “Our findings call for attention to potential inequity in quality of care at EDs for AUB evaluation,” the authors write.
Huang and colleagues also found that patients aged 46-55 were less likely to receive transvaginal ultrasound imaging/orders and follow-up referrals/recommendations. They point out that patients this age are often in the perimenopausal transition and experiencing irregular menstrual cycles, so providers might assume AUB is a sign of perimenopause—but, they note, women sometimes find their providers to be dismissive of perimenopausal symptoms, which can make it challenging to receive appropriate care.
“Appropriate follow-up for symptoms that might indicate cancer is an essential aspect of health care,” said Karen McDonnell, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “We hope these findings will encourage emergency departments to examine their procedures and make any improvements necessary to deliver equitable care.”
“Diagnostic Evaluation for Abnormal Uterine Bleeding at Emergency Departments in the United States” has been published in the September/October 2025 issue of Women’s Health Issues.