Premenopausal abnormal uterine bleeding and risk of endometrial cancer
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Abstract
Endometrial biopsies are undertaken in premenopausal women with abnormal uterine bleeding but the risk of endometrial cancer or atypical hyperplasia is unclear.
To conduct a systematic literature review to establish the risk of endometrial cancer and atypical hyperplasia in premenopausal women with abnormal uterine bleeding.
Search of PubMed, Embase and the Cochrane Library from database inception to August 2015.
Studies reporting rates of endometrial cancer and/or atypical hyperplasia in women with premenopausal abnormal uterine bleeding.
Data were independently extracted by two reviewers and cross-checked. For each outcome, the risk and a 95% CI were estimated using logistic regression with robust standard errors to account for clustering by study.
Sixty-five articles contributed to the analysis. Risk of endometrial cancer was 0.33% (95% CI 0.23–0.48%,
The risk of endometrial cancer or atypical hyperplasia in premenopausal women with abnormal uterine bleeding is low. Premenopausal women with abnormal uterine bleeding should first undergo conventional medical management. Where this fails, the presence of IMB and older age may be indicators for further investigation. Further research into the risks associated with age and the cumulative risk of co-morbidities is needed.
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This is the final version of the article. It first appeared from Wiley via https://doi.org/10.1111/1471-0528.14385