A 58-year-old woman has vaginal bleeding two years after her last period. What is the appropriate pathway?
Answer and explanation
Correct answer: D. Referral on the suspected cancer pathway for endometrial assessment
- Step 1: Postmenopausal bleeding can be the first sign of endometrial cancer. Step 2. NICE advises referral for women aged 55 and over with postmenopausal bleeding, with transvaginal ultrasound or hysteroscopy. Answer: Referral on the suspected cancer pathway for endometrial assessment. Why not the others: Reassurance delays diagnosis. Oestrogen would not exclude cancer. A cervical smear does not assess the endometrium.
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