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Rate of Significant Endometrial Pathology in Women at Low Risk for Endometrial Hyperplasia or Cancer Presenting with Abnormal Uterine Bleeding

Authors Sattanakho P, Kleebkaow P, Sangkomkumhang U, Booranabunyat S, Buppasiri P

Received 4 December 2019

Accepted for publication 17 January 2020

Published 11 February 2020 Volume 2020:11 Pages 13—18

DOI https://doi.org/10.2147/POR.S240930

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor David Price


Pattarawadee Sattanakho,1 Pilaiwan Kleebkaow,1 Ussanee Sangkomkumhang,2 Sukjai Booranabunyat,3 Pranom Buppasiri1

1Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 2Department of Obstetrics and Gynecology, Khon Kaen Regional Hospital, Khon Kaen, Khon Kaen Province, Thailand; 3Department of Obstetrics and Gynecology, Mahasarakham Hospital, Mahasarakham Province, Thailand

Correspondence: Pranom Buppasiri
Department of Obstetrics and Gynaecology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
Tel +66-43-202489
Fax +66-43-348395
Email bprano@kku.ac.th

Background and Objectives: To determine the rate of significant endometrial abnormalities in premenopausal women at low risk for endometrial hyperplasia and cancer presenting with abnormal uterine bleeding (AUB).
Patients and Methods: This descriptive study was conducted from January 1, 2016 to March 31, 2019. The inclusion criteria were premenopausal women, 35– 50 years, presenting with AUB, low risk for endometrial hyperplasia or endometrial cancer, and having undergone endometrial sampling or uterine curettage. Nulliparous, obesity, diabetes mellitus, polycystic ovary syndrome, chronic anovulation, infertility, tamoxifen therapy and/or a family history of uterine, ovarian, breast and colon cancer were excluded. Data regarding baseline characteristics were collected, and histopathology reports were reviewed.
Results: During the study period, 644 subjects were recruited, 557 of whom had adequate endometrial tissue for histopathology study. The pathology demonstrated benign in most cases (96%). The rate of significant abnormal endometrial pathology was 4% (23 cases) including 19 cases of endometrial hyperplasia without atypia (3.3%), and 4 cases of endometrial cancer (0.7%).
Conclusion: The rate of significant abnormal endometrial pathology in premenopausal women at low risk for endometrial hyperplasia or endometrial cancer presenting with AUB was very low. This information should be incorporated into the counseling process regarding the risks and benefits of endometrial sampling.

Keywords: abnormal uterine bleeding, endometrial sampling, endometrial pathology

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