| Autor: |
Visser, Nicole C.M., Sparidaens, Ellen M., Brink, Jan‐Willem, Breijer, Maria C., Boss, Erik A., Veersema, Sebastiaan, Siebers, Albert G., Bulten, Johan, Pijnenborg, Johanna M.A., Bekkers, Ruud L.M., van den Brink, Jan-Willem |
| Předmět: |
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| Zdroj: |
Acta Obstetricia et Gynecologica Scandinavica; Dec2016, Vol. 95 Issue 12, p1418-1424, 7p |
| Abstrakt: |
Introduction: Women with postmenopausal bleeding and endometrial thickness >4 mm undergo endometrial sampling to exclude endometrial cancer. The aim of this study is to investigate the relative risk of developing endometrial cancer in a prospective cohort after initial work-up for postmenopausal bleeding showing reassuring histology or insufficient sampling.Material and Methods: All women presenting with postmenopausal bleeding were prospectively included from January 2009 to April 2011. Follow-up data were collected from patient charts and PALGA (Dutch Pathology Registry). Hazard ratios for endometrial cancer were determined by calculating standardized incidence ratios.Results: A total of 668 women were included and 568 women were available for follow-up [median follow-up time 47 (range 7-63) months]. Women who presented with postmenopausal bleeding, endometrial thickness >4 mm and hyperplasia without atypia on biopsy at the first presentation showed a significantly increased risk (standardized incidence ratio 17.15, 95% confidence interval 1.96-61.93) of being diagnosed with endometrial cancer during the first four years of follow up compared with the age-specific population. All women that developed endometrial cancer after initial reassuring histology presented with recurrent postmenopausal bleeding. None of the women with endometrial thickness >4 mm and no or insufficient sample for histology at the first presentation developed endometrial cancer during the follow up.Conclusions: Although in general, women with endometrial hyperplasia without atypia are considered to have a low risk for cancer, we observed a significant long-term risk of endometrial cancer after postmenopausal bleeding. Whether additional diagnostics or a more stringent follow-up regimen would be cost-effective, needs to be studied. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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