Fellow Maya Gross and GRACE Center team publish new paper

Dr. Maya Gross, 3rd Year Fellow in our Gynecologic Oncology program, was first author for paper "Physician Uncertainty, Beliefs, and Practices on Peri- and Postmenopausal Bleeding Evaluation and the Impact on Risks for Black Patients at Risk for Endometrial Cancer", co-authored alongside Department of OBGYN colleagues Patrice Williams, Minerva Orellana, and Dr. Kemi Doll. Dr. Gross is quoted below, discussing the recent study.

Why did you choose to research this topic?

This project was designed as a follow-up to a limited amount of survey-based data that suggested that providers in multiple specialties who care for patients at risk for endometrial cancer have limited knowledge of national guidelines to evaluate peri- and postmenopausal bleeding, as well as limited knowledge about racial disparities in endometrial cancer. We designed this qualitative, interview-based study to get a more detailed understanding of provider practice patterns and knowledge base of these topics.  Additionally, we sought to evaluate provider perceptions of a biopsy-first or tissue-sampling first approach to the evaluation of peri- and postmenopausal bleeding, given emerging evidence of decreased sensitivity of transvaginal ultrasound for the detection of endometrial cancer in patients at high risk for endometrial cancer.

What do you consider the biggest takeaway from this paper?

I think the biggest takeaway from this paper echoes what has been seen with other disease types: it is challenging for primary care and non-specialized providers to stay up to date on all existing guidelines, and providers often do not refer to existing guidelines when evaluating peri- and postmenopausal bleeding. New research that hasn't yet been incorporated into guidelines is also not reaching front-line providers. Providers are interested in and open to adjusting their approach to provide the best possible care for their patients.

What do you see as the potential impact of this work?

This project confirms that we need to help disseminate guidelines and new research to providers of all specialties; publishing guidelines alone is not sufficient.  We hope to take the findings of this study to implement a provider education toolkit for best practices in the evaluation of peri- and postmenopausal bleeding for physicians at the University of Washington. If successful, this toolkit could be a template for other health systems to employ.