Risk assessment for endometrial cancer in women with abnormal vaginal bleeding: Results from the prospective IETA‐1 cohort study. Issue 1 (7th February 2022)

• Record Type: Journal Article
• Authors: Verbakel, Jan Yvan; Heremans, Ruben; Wynants, Laure; Epstein, Elisabeth; De Cock, Bavo; Pascual, Maria Angela; Leone, Francesco Paolo Giuseppe; Sladkevicius, Povilas; Alcazar, Juan Luis; Van Pachterbeke, Catherine; Jokubkiene, Ligita; Fruscio, Robert; Bourne, Tom; Van Calster, Ben; Timmerman, Dirk; Van den Bosch, Thierry
• Is Part Of: International journal of gynaecology and obstetrics. Volume 159:Issue 1(2022)
• Page Start: 103
• Page End: 110
• Publication Date: 2022-02-07
• Subjects: endometrial neoplasms -- endometrium -- uterine hemorrhage; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.14097
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Objective: To investigate the association between personal history, anthropometric features and lifestyle characteristics and endometrial malignancy in women with abnormal vaginal bleeding. Methods: Prospective observational cohort assessed by descriptive and multivariable logistic regression analyses. Three features—age, body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters), and nulliparity—were defined a priori for baseline risk assessment of endometrial malignancy. The following variables were tested for added value: intrauterine contraceptive device, bleeding pattern, age at menopause, coexisting diabetes/hypertension, physical exercise, fat distribution, bra size, waist circumference, smoking/drinking habits, family history, use of hormonal/anticoagulant therapy, and sonographic endometrial thickness. We calculated adjusted odds ratio, optimism‐corrected area under the receiver operating characteristic curve (AUC), R 2, and Akaike's information criterion. Results: Of 2417 women, 155 (6%) had endometrial malignancy or endometrial intraepithelial neoplasia. In women with endometrial cancer median age was 67 years (interquartile range [IQR] 56–75 years), median parity was 2 (IQR 0–10), and median BMI was 28 (IQR 25–32). Age, BMI, and parity produced an AUC of 0.82. Other variables marginally affected the AUC, adding endometrial thickness substantially increased the AUC in postmenopausal women. Conclusion: Age, parity, and BMI help in the assessment of endometrial cancer risk in women with abnormal uterine bleeding. Other patient information adds little, whereas sonographic endometrial thickness substantially improves assessment. Abstract : Age, body mass index, and parity affect the risk of endometrial cancer in women with abnormal uterine bleeding. Other clinical factors are less important.