Hysteroscopic chasing for endometrial cancer in a low-risk population: risks of overinvestigation
| Autor: | Lorenzo Monasta, Emanuele Filippo Galati, Federica Scrimin, Giuseppe Ricci, Uri Wiesenfeld |
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| Přispěvatelé: | Scrimin, Federica, Wiesenfeld, Uri, Galati, Emanuele F., Monasta, Lorenzo, Ricci, Giuseppe |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Risk medicine.medical_specialty Low risk population Medical Overuse Hysteroscopy Endometrium 03 medical and health sciences Polyps 0302 clinical medicine Appropriateness Endometrial cancer Obstetrics and Gynecology Outcome Assessment Health Care Humans Medicine Medical history 030212 general & internal medicine Overdiagnosis Uterine Neoplasm Aged Retrospective Studies Ultrasonography Aged 80 and over 030219 obstetrics & reproductive medicine medicine.diagnostic_test Uterine Hemorrhage business.industry Obstetrics Retrospective cohort study General Medicine Middle Aged medicine.disease Endometrial Neoplasms Perimenopause Postmenopause Uterine Neoplasms Female Appropriatene business |
| Zdroj: | Archives of Gynecology and Obstetrics. 293:851-856 |
| ISSN: | 1432-0711 0932-0067 |
| DOI: | 10.1007/s00404-015-3868-x |
| Popis: | PURPOSE:To evaluate the appropriateness of the indications for hysteroscopy done, in fertile and postmenopausal women, for the detection of endometrial cancer. METHODS: A retrospective analysis of 2673 consecutive women who underwent office hysteroscopy chasing for endometrial cancer between January 2012 and June 2014. According to their medical history only low-risk women entered the study. RESULTS: A total of 1070 patients entered the study. The main outcome measure was the appropriateness of the indications for hysteroscopy. Appropriateness was assessed on the basis of guidelines of scientific societies and histologic report. According to the algorithm developed for appropriateness, 44 % of procedures resulted in being inappropriate. In reproductive-aged women 57 % of hysteroscopies were inappropriate. In postmenopausal women inappropriate hysteroscopies were 45 %. In reproductive-aged women, the reasons for inappropriateness were: absence of abnormal uterine bleeding (AUB) or AUB without a trial of progestin therapy. In postmenopausal women, the reasons for inappropriateness were: ultrasound report of endometrial thickening or polyp without bleeding. CONCLUSIONS: Hysteroscopy is often recommended for inappropriate indications. More evidence is needed to identify the risks of overinvestigation, overdiagnosis, and related overtreatment and to better identify the threshold beyond which benefits are likely to outweigh harms. |
| Databáze: | OpenAIRE |
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