Risk Assessment of Endometrial Hyperplasia and Cancer in Premenopausal Women with Abnormal Uterine Bleeding
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Abstract
Objectives: Our goal was to develop an endometrial sampling protocol for the early detection and treatment of endometrial hyperplasia and endometrial cancer (EH/EC) in premenopausal women experiencing abnormal uterine bleeding.
Materials and Methods: A prospective cohort study on premenopausal women with abnormal uterine bleeding who underwent endometrial sampling was conducted at Ratchaburi Hospital. Each patient’s risk factors and conducted clinical assessments, including pelvic examinations and transvaginal ultrasound were documented. To determine the likelihood of EH/EC, univariate and stepwise logistic regression analyses were used.
Results: Among 200 eligible premenopausal women with abnormal uterine bleeding who received endometrial sampling, histological analysis identified EH in 14 women (7%) and EC in 7 women (3.5%). Stepwise logistic regression revealed a significant association of EH/EC with a body mass index of 30 kg/m2 or higher, tamoxifen usage, and an endometrial thickness exceeding 10 mm (p = 0.004, 0.041, and 0.001, respectively). The presence of two or three of these risk factors significantly increased the association with EH/EC (p < 0.001).
Conclusion: Obesity, tamoxifen usage, and endometrial thickness greater than 10 mm were strong indicators of EH/EC. Endometrial sampling is recommended for patients exhibiting more than one of these risk factors.
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