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The following is a summary of “Facilitators and Barriers to Acceptability of a Biopsy-First Approach in the Diagnostic Evaluation for Endometrial Cancer Among Black Women,” published in the March 2025 issue of American Journal of Obstetrics & Gynecology by Alson et al. 

Limited data exist on Black individuals’ perspectives on biopsy as a primary diagnostic step for endometrial cancer despite its potential to improve early detection.  

Researchers conducted a retrospective study to explore factors influencing the acceptability of a biopsy-first approach for ruling out cisgender Black women with endometrial cancer.  

They organized 3 focus groups with self-identified cisgender Black women at risk for endometrial cancer. Convenience sampling was used through social media and newsletter networks. A focus group guide based on the Theory of Planned Behavior included questions on past experiences, initial impressions, an educational presentation, and final thoughts on a biopsy-first approach. Transcripts were coded using an inductive and deductive method and analyzed through directed and thematic content analysis.  

The results showed that 25 women participated in focus groups, with 6–10 individuals per group. Initially, many expressed apprehensions toward a biopsy-first approach due to past negative experiences and concerns about medical racism. However, by the end of the discussions, overall acceptance of biopsy as a priority test for ruling out endometrial cancer was observed. Barriers included prior negative experiences, mismatched pain expectations, and awareness of medical racism. Facilitators included fostering patient-provider trust by acknowledging medical racism, providing information, offering personalized recommendations, and racial concordance in care. Additionally, health education on racial disparities in endometrial cancer, biopsy procedures, risks of delaying biopsy, emotional benefits, and varying pain experiences improved acceptability.  

Investigators concluded that patient-centered communication, including trust-building, shared decision-making, and education, was crucial for Black cisgender women’s acceptance of biopsy as a first-line approach to evaluating abnormal bleeding and improving endometrial cancer diagnosis. 

Source: ajog.org/article/S0002-9378(25)00157-7/abstract