Endometriosis Screening Tool May Cut Diagnosis Delays

Key Points

• Researchers from the University of Queensland developed a rapid SAFE score screening tool to help identify patients at risk of endometriosis.
• The 5-minute questionnaire uses six clinical questions related to pelvic pain, menstrual symptoms, and family history.
• The tool is designed to reduce the typical 6–8 year delay in endometriosis diagnosis and support earlier specialist referral.
• It was developed using data from more than 9,000 women in the Australian Longitudinal Study on Women’s Health.
• Researchers are now evaluating its use in primary care and pelvic pain clinics, with possible future integration into a mobile application.

Endometriosis Screening Tool May Reduce Diagnostic Delays

Early recognition of endometriosis remains a persistent clinical challenge. Researchers from the University of Queensland have developed a 5-minute screening tool called the Simplified Adolescent Factors for Endometriosis (SAFE) score, designed to help clinicians quickly identify adolescents and young women at risk of the condition.

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus, often causing chronic pelvic pain, heavy menstrual bleeding, infertility, and reduced quality of life. Despite its prevalence, diagnosis frequently takes six to eight years, partly due to non-specific symptoms and normalization of menstrual pain.

The SAFE score introduces a rapid clinical screening method that may support earlier referral and intervention in primary care settings.

What Is the SAFE Score for Endometriosis Screening?

The SAFE score is a short questionnaire consisting of six targeted questions aimed at identifying symptoms and risk factors associated with endometriosis.

Patients are asked whether they:

• Frequently experience pelvic pain
• Have sought medical treatment for pelvic pain
• Use pain medications for menstrual pain
• Experience heavy menstrual bleeding
• Have painful periods
• Have a family history of endometriosis

Each response contributes to a point-based scoring system, allowing clinicians to estimate the likelihood that a patient may have endometriosis. Higher scores indicate a greater need for specialist evaluation or diagnostic imaging.

The tool was developed using data from more than 9,000 participants in the Australian Longitudinal Study on Women’s Health, enabling researchers to identify patterns and risk indicators associated with the disease.

Importantly, while the screening tool can be used in adults, it was specifically designed to detect risk factors in adolescents soon after the onset of menstruation, when symptoms may first appear.

Why Early Endometriosis Detection Matters for Patient Care

Endometriosis affects up to 11% of women of reproductive age, yet diagnosis often occurs in the late twenties, frequently when patients begin seeking fertility care.

Delayed diagnosis may occur due to:

• Overlapping symptoms with other gynecologic conditions
• Limited awareness among patients and clinicians
• Misinterpretation of menstrual pain as normal

Currently, laparoscopy is commonly required to confirm diagnosis, although researchers and clinicians are working toward non-invasive diagnostic approaches such as ultrasound or MRI.

Early detection could significantly influence fertility planning and treatment strategies. Studies suggest that common fertility treatments like ovulation induction may be less effective in patients with endometriosis compared with assisted reproductive options such as IVF.

The research team plans to evaluate the SAFE score in general practice and pelvic pain clinics, while also exploring the feasibility of converting the questionnaire into a digital screening application.

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With Endometriosis Awareness Month observed in March, the SAFE screening tool highlights the importance of improving early identification and clinical pathways for patients experiencing chronic pelvic pain.

Source:

University of Queensland