NICE has today (11 November 2024) published its updated guideline
on the diagnosis and management of endometriosis.
The guideline makes new recommendations and updates existing ones
on diagnosing a condition that affects approximately 1.5 million
women of reproductive age in the UK [1].
Recent reports from both the National Confidential Enquiry into
Patient Outcome and Death (NCEPOD) and Endometriosis UK have
highlighted problems with the diagnosis of endometriosis in the
UK. According to Endometriosis UK, the average length of
time to diagnosis is 8-10 years [3], and as NCEPOD has pointed
out, a delay in diagnosis is a significant issue as it can lead
to prolonged suffering, ill health, and risks to fertility [2].
The update aims to help address these issues by:
- Recommending specialist ultrasound as an alternative to MRI
for investigating suspected endometriosis in secondary care.
- Recommending early transvaginal ultrasound in all people with
suspected endometriosis, even if the pelvic or abdominal
examination is normal.
- Making firmer and clearer recommendations regarding referral.
- Providing greater clarity regarding the pathway of care for
women with suspected endometriosis.
Professor Jonathan Benger, chief medical officer and
interim director of the Centre for Guidelines at NICE,
said: “This guideline will help healthcare professionals
detect endometriosis early, to close the symptom to diagnosis gap
and ensure more timely treatment.
“We recognise that capacity in endometriosis clinics remains an
issue, and that waiting times to be seen in secondary care can
sometimes be lengthy.
“However, NICE also recognises the serious problems which people
with suspected endometriosis face in accessing the care they need
and the consequences of delayed diagnosis and treatment. This
update aims to help tackle these problems by clarifying what high
quality care for women with suspected endometriosis should be.
“It is also sometimes the case that women are not always informed
when endometriosis is suspected and do not have the pathway of
care explained to them. This guideline should help ensure women
with suspected endometriosis are informed about what to expect,
and that appropriate information is provided throughout their
care journey.”
Women's Health Minister said:
“Endometriosis can be debilitating and women with this condition
have been failed for far too long.
“This government is determined to overhaul women's healthcare and
these changes will help patients receive an accurate and
timely diagnosis, benefitting over a million women affected.
“Our 10-Year Health Plan, backed by a £22.6 billion increase in
day-to-day health spending, will help cut waiting lists in
gynaecology and get women the support they need.”
Endometriosis is a chronic long-term condition that develops when
cells normally found in the womb are present elsewhere in the
body such as the bladder or bowel. It can have a significant
physical, sexual, psychological and social impact.
References
- Endometriosis Facts and Figures. Endometriosis UK. Accessed online.
- Endometriosis: A Long and Painful Road. National Confidential
Enquiry into Patient Outcome and Death. Accessed online.
- “Dismissed, ignored and belittled' The long road to
endometriosis diagnosis in the UK. Endometriosis UK. Accessed online.
