Endometrial carcinoma in asymptomatic post-menopausal women with a thickened endometrium and its influencing factors - A cross-sectional study.
Journal of family medicine and primary care
Background:A thickened endometrium upon trans-vaginal ultrasound in asymptomatic post-menopausal women always poses a clinical dilemma. Objectives:To investigate the frequency of endometrial malignancies by histopathological examination and identify the associated factors influencing the thickened endometrium in asymptomatic post-menopausal women. Methods:In trans-vaginal ultrasonography, we enrolled 72 asymptomatic post-menopausal women with a thickened endometrium (>5 mm). Dilatation and curettage were performed for all cases, and the specimen was sent for histopathological examination. According to the data distribution, all the continuous variables were stated as mean ± standard deviation/median (inter-quartile range), categorical variables were expressed in frequency, and percentage will be compared using the Chi-square test/Fisher exact test. Results:In our study, most of the women were multipara. The age of post-menopausal women ranged from 46 to 68 years, and the mean duration of menopause was 8.10. The most common histological findings were benign in 72.22% of the cases. We identified pre-malignant and malignant lesions of the endometrium in 18.05% and 9.72% of the cases, respectively. To predict the condition of the lesion, we noticed no definite cut-off value of endometrial thickness to indicate the state of the lesion. We observed that none of the patient's characteristics showed a significant difference with a thickened endometrium. Conclusion:We observed an increased frequency of endometrial pathology irrespective of the presence or absence of risk factors. The result of this study is justified enough for the need of further evaluation of a thickened endometrium in asymptomatic post-menopausal women.
10.4103/jfmpc.jfmpc_2347_21
Significance of incidentally thick endometrial echo on transvaginal ultrasound in postmenopausal women.
Goldstein Steven R
Menopause (New York, N.Y.)
Postmenopausal bleeding is "cancer until proven otherwise." A thin distinct endometrial echo on transvaginal ultrasound has a risk of malignancy of 1 in 917 and does not require an endometrial biopsy. If the endometrial echo is poorly visualized, then in such women, saline infusion sonohysterography is an appropriate next step. The prevalence of asymptomatic endometrial thickening (mostly due to inactive polyps) is high, approximately 10% to 17% of postmenopausal women. The risk of malignancy in such polyps is low (approximately 0.1%), and in structures that mimic polyps, it is also low (0.3%). The incidence of serious complications from an operative intervention in such postmenopausal women is not insignificant (1.3%-3.6%). Thus, automatic intervention in such women, without any high-risk status, is not warranted.
10.1097/gme.0b013e31820ad00b
Clinicopathological features of endometrial lesions in asymptomatic postmenopausal women with thickened endometrium.
Menopause (New York, N.Y.)
OBJECTIVE:To analyze the clinical and pathological features of asymptomatic postmenopausal women with an incidentally detected increase in endometrial thickness (ET) by transvaginal ultrasound examination and discuss the cutoff value of ET for the timely discovery of endometrial malignancy. METHODS:This was a retrospective study of postmenopausal women with asymptomatic thickened endometrium (greater than or equal to 5 mm) screened by transvaginal ultrasound who were referred to the gynecology department at Xuanwu Hospital between January 2018 and March 2021. Data on participant demographics, clinical characteristics, and histopathology outcomes were collected. We stratified the participants into the benign group and malignant group according to pathology results and assessed differences between the two groups. A receiver operating characteristic curve was used to identify the cutoff value of ET for predicting endometrial malignancy in postmenopausal women with asymptomatic thickened endometrium. RESULTS:A total of 163 eligible cases were included in the analysis. The results showed that only ET was significantly different between the two groups. The median ET was significantly higher in the malignant group than in the benign group (1.20 vs 0.80, P = 0.023). The optimal cutoff value of ET was 10 mmwith the maximum AUC (0.881, 95% CI 0.810-0.952, P = 0.024), and the sensitivity and specificity for the diagnosis of endometrial malignancy were 100%and 80%, respectively. Among the 47 women with ET ≥ 10mm, the prevalence of endometrial malignancy was 6.3%, which was significantly higher than that among women with ET < 10mm ( P = 0.023). CONCLUSION:For postmenopausal women with asymptomatic endometrial thickening, the prevalence of endometrial malignancy is significantly higher when ET is ≥ 10 mm. If ET is ≥ 10mm, further histopathological testing should be recommended to exclude endometrial malignancy. Further large-sample and prospective studies are needed to determine the predictive value of ET.
10.1097/GME.0000000000001993
A Review of the Risk Factors Associated with Endometrial Hyperplasia During Perimenopause.
International journal of women's health
Background:Endometrial hyperplasia, characterized by excessive growth leading to endometrial thickening, is commonly observed in the premenopausal period. Its prevalence in postmenopausal women is approximately 15%, peaking between ages 50 and 60. This condition often manifests as abnormal uterine bleeding and can progress to malignancy, with varying risks depending on the type of hyperplasia. Purpose:This study aims to investigate the factors influencing endometrial thickness during the perimenopausal period and raise awareness among healthcare professionals about the importance of evaluating and caring for individuals with endometrial hyperplasia. Methods:Studies examining the association between various factors such as diabetes mellitus, hypertension, age, estrogen replacement therapy, anovulatory disorders, smoking, medications, genetic factors, and endocrine-related proteins and the development of endometrial hyperplasia were reviewed. The literature search encompassed relevant databases, including PubMed, Scopus, and Web of Science. Results:Research findings indicate significant associations between changes in gene expression of several factors and the development of endometrial hyperplasia. Notably, the risk of progression to cancer varies between non-atypical and atypical hyperplasia cases. Factors such as diabetes mellitus, hypertension, age, estrogen replacement therapy, anovulatory disorders, smoking, medications, Lynch syndrome, tamoxifen use, and alterations in gene expression of TNF-α, EGF, IGF-1, IGF-1R, and PTEN have been implicated in the pathogenesis of endometrial hyperplasia. Conclusion:This study underscores the importance of understanding the factors influencing endometrial thickness during the perimenopausal period. It emphasizes the pivotal role of healthcare professionals in evaluating and caring for individuals with this condition.
10.2147/IJWH.S481509
Do endometrial lesions require removal? A retrospective study.
Jiang Ting,Yuan Qing,Zhou Qin,Zhu Yiping,Lv Siji,Cao Yanling,Wang Qin,Li Kunming,Zhao Dong
BMC women's health
BACKGROUND:This study aimed to evaluate the management of asymptomatic intrauterine lesions detected by ultrasonography. METHODS:Patients who underwent diagnostic hysteroscopy for asymptomatic lesions, including pre- and post-menopausal endometrial polyps, post-menopausal endometrial thickening (ET ≥5 mm) and reduplicative endometrial heterogeneity detected by transvaginal ultrasonography (TVUS), were recruited for this study. RESULTS:In the 792 recruited patients, the symptom-free focal masses within the uterine cavity detected by TVUS included 558 patients with pre- or post-menopausal endometrial polyps and 234 patients with postmenopausal endometrial thickening. No pre-menopausal patient presented with carcinoma. The polyp diameter (PD) was not identified as an independent risk factor for malignancy in this study. A significant difference (P = 0.036, < 0.05) in both benign and malignant endometrial lesions was observed between two groups of post-menopausal women stratified using an endometrial thickness cut-off of ≥11 mm. The TVUS was highly sensitive (94%) for pre-menopausal polyps. This technique had a specificity and positive predictive value of 84.4 and 92.7%, respectively, for postmenopausal polyps. The TVUS was clearly valuable for ruling out polyps, as indicated by a negative likelihood ratio (LR-) of 0.087. Among postmenopausal women with endometrial thickening, the area under the receiver operating characteristic curve was 0.828 (P < 0.001). An ET cut-off value of 12.5 mm yielded a sensitivity of 72.7% and specificity of 86%. CONCLUSION:We recommend follow-up alone for women with asymptomatic uterine polyps, particularly those who are pre-menopausal. Additionally, gynaecologists should consider risk factors such as age, obesity, polycystic ovarian syndrome, and diabetes. Prospective long-term follow-up studies should be conducted after hysteroscopic polypectomy to evaluate the recurrence rate of endometrial lesions.
10.1186/s12905-019-0756-8
Asymptomatic Endometrial Thickening of 8 mm or Greater on Postcontrast Computed Tomography in Postmenopausal Women Is a Predictor of Endometrial Cancer.
Journal of computer assisted tomography
OBJECTIVES:The aim of this study was to assess the value of opportunistic endometrial thickness measurement on postcontrast computed tomography (CT) as a predictor of endometrial cancer in asymptomatic postmenopausal women. METHODS:For this Health Insurance Portability and Accountability Act-compliant, institutional review board-approved retrospective study with waiver of informed consent, our institution's tumor board database was searched for postmenopausal patients, diagnosed with endometrial cancer between August 2003 and December 2016 and who had a postcontrast pelvic CT within 12 months prior to the cancer diagnosis (while they were asymptomatic)-"cancer group." Same number of age-matched patients who had postcontrast pelvic CT constituted the noncancer control group. Endometrial thickness was measured on sagittal postcontrast CT images. RESULTS:After applying exclusion criteria, 22 asymptomatic patients who were diagnosed with endometrial cancer within 1 year after the CT comprised the cancer group, and 22 age-matched patients comprised the control group. Average endometrial thickness was 18.7 ± 14.8 mm (range, 2-70 mm) in the cancer group and 3.6 ± 2.5 mm (range, 1.8-10 mm) in the control group (P < 0.0001). Endometrial thickness 8 mm or greater predicted endometrial cancer with 86% sensitivity and 91% specificity in these asymptomatic patients. Area under the receiver operating characteristic curve for endometrial thickness as a predictor of endometrial cancer was 0.92. CONCLUSIONS:Endometrial thickness 8 mm or greater on sagittal postcontrast CT was shown to have high sensitivity in opportunistic detection of endometrial cancer in asymptomatic postmenopausal women.
10.1097/RCT.0000000000000796
Meta-analysis on Asymptomatic Endometrial Thickening and Its Association with Endometrial Cancer Risk in Women Over 50 Years of Age.
Alternative therapies in health and medicine
Purpose:This study systematically assesses the correlation between asymptomatic endometrial thickening after the age of 50 and the risk of endometrial cancer (EC). Methods:A comprehensive search was conducted using the Cochrane Library, Web of Science, PubMed, ProQuest, and Chinese biomedical literature databases Wanfang, Weipu, and CNG until August 2022. The included literature was analyzed using RevMan 5.3 software to explore heterogeneity in each study. Results:Five studies were finally included. The assessment of odds ratio (OR) heterogeneity between women with endometrial thickening and the risk of EC showed P = .18, I2=95%, indicating significant heterogeneity. A random-effects model was applied for meta-analysis, revealing a result of 0.96, 95% CI (0.92, 1.02), P = .18, indicating no statistical significance between the two groups (P > .05). The funnel plot demonstrated asymmetry, suggesting evident publication bias. Conclusion:There is no consistent correlation between asymptomatic endometrial thickening and the occurrence of EC in individuals over 50 years of age.
Asymptomatic endometrial thickening.
Wolfman Wendy,Leyland Nicholas,Heywood Mark,Singh Sukhbir S,Rittenberg David Allan,Soucy Renée,Allaire Catherine,Awadalla Alaa,Best Carolyn,Dunn Sheila,Leroux Nathalie,Potestio Frank,Senikas Vyta,Wallace Sarah,Menzies Rebecca,
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
OBJECTIVE:To formulate clinical recommendations for the assessment of endometrial thickening when it is found on ultrasound in a postmenopausal patient without bleeding. OUTCOMES:Ensure that women with asymptomatic thickening and endometrial polyps found on ultrasound are managed appropriately. EVIDENCE:Published literature was retrieved through searches of English language articles from the EMBASE, Cochrane, and PubMed databases for relevant peer-reviewed articles dating from 1970 to 2009, using appropriate controlled vocabulary (e.g., "asymptomatic endometrial thickness," "endometrial cancer," "postmenopausal bleeding," "transvaginal ultrasonography," "endometrial biopsy" and "endometrial polyp"). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and incorporated in the guideline to April 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. VALUES:The level of evidence was determined according to the criteria established by the Canadian Task Force on Preventative Health Care (Table). Recommendations are ranked according to this method. BENEFITS, HARMS, AND COSTS:It is anticipated that the adoption of these recommendations would save postmenopausal women unnecessary anxiety, pain, and risk of procedural complication. It is also expected to decrease the cost to the health system by eliminating unnecessary interventions.
10.1016/s1701-2163(16)34690-4
The relationship between endometrial thickening and endometrial lesions in postmenopausal women.
Archives of gynecology and obstetrics
PURPOSE:The study aims to investigate the relationship between endometrial thickening and endometrial lesions in postmenopausal women. METHODS:Totally 390 postmenopausal patients with endometrial thickening ≥ 5 mm were enrolled from June 2016 to April 2020, among whom 188 patients were asymptomatic and 202 patients were symptomatic. RESULTS:There were 50 cases with endometrial cancer and precancerous lesions and 150 cases with benign lesions in the symptomatic group, significantly higher than that in the asymptomatic group. The most common pathological type in the asymptomatic group was endometrial polyp. In the asymptomatic group, statistically significant differences were found in endometrial thickness between patients with endometrial cancer and precancerous lesion (group B) and those with benign lesions and non-organic lesions (group A). Statistically significant differences were also found in age, endometrial thickness, hypertension, full-term delivery time and miscarriage times between group A and group B. Regression analysis indicated that hypertension and endometrial thickness were independent risk factors for endometrial cancer and precancerous lesions in the symptomatic group. ROC analysis showed that 10.5 mm was the optimal threshold for predicting endometrial cancer and precancerous lesions in the asymptomatic group, with sensitivity of 100% and specificity of 78.3%. CONCLUSION:The incidence of endometrial cancer and precancerous lesions in postmenopausal women with endometrial thickening and vaginal bleeding is higher than that of asymptomatic women. The endometrial thickening in postmenopausal asymptomatic women is mainly benign, and the threshold for predicting endometrial cancer and precancerous lesions is 10.5 mm.
10.1007/s00404-022-06734-7
No. 249-Asymptomatic Endometrial Thickening.
Wolfman Wendy
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
OBJECTIVE:To formulate clinical recommendations for the assessment of endometrial thickening when it is found on ultrasound in a postmenopausal patient without bleeding. OUTCOMES:Ensure that women with asymptomatic thickening and endometrial polyps found on ultrasound are managed appropriately. EVIDENCE:Published literature was retrieved through searches of English language articles from the EMBASE, Cochrane, and PubMed databases for relevant peer-reviewed articles dating from 1970 to 2009, using appropriate controlled vocabulary (e.g., "asymptomatic endometrial thickness," "endometrial cancer," "postmenopausal bleeding," "transvaginal ultrasonography," "endometrial biopsy" and "endometrial polyp"). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and incorporated in the guideline to April 2010. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. VALUES:The level of evidence was determined according to the criteria established by the Canadian Task Force on Preventive Health Care (Table 1). Recommendations are ranked according to this method. BENEFITS, HARMS, AND COSTS:It is anticipated that the adoption of these recommendations would save postmenopausal women unnecessary anxiety, pain, and risk of procedural complication. It is also expected to decrease the cost to the health system by eliminating unnecessary interventions. RECOMMENDATIONS:
10.1016/j.jogc.2018.03.005
Guideline No. 451: Asymptomatic Endometrial Thickening in Postmenopausal Women.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
OBJECTIVE:To formulate strategies for clinical assessments for endometrial thickening on ultrasound in a postmenopausal woman without bleeding. TARGET POPULATION:Postmenopausal women of any age. OUTCOMES:To reduce unnecessary invasive interventions and investigations in women with asymptomatic endometrial thickening while selectively investigating women at risk for endometrial cancer. BENEFITS, HARMS, AND COSTS:It is anticipated that the adoption of these recommendations would save postmenopausal women unnecessary anxiety, pain, and risk of procedural complications. It is also expected to decrease the cost to the health care system by eliminating unnecessary interventions. EVIDENCE:English language articles from Medline, Cochrane, and PubMed databases for relevant peer-reviewed articles dating from 1995 to 2022 (e.g., asymptomatic endometrial thickness, endometrial cancer, postmenopausal bleeding, transvaginal ultrasound, endometrial biopsy, cervical stenosis, hormone therapies and the endometrium, tamoxifen, tibolone, aromatase inhibitors). Results were restricted to systematic reviews and meta-analyses, randomized controlled trials/controlled clinical trials, and observational studies. VALIDATION METHODS:The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations). INTENDED AUDIENCE:Physicians, including gynaecologists, obstetricians, family physicians, radiologists, pathologists, and internists; nurse practitioners and nurses; medical trainees, including medical students, residents, and fellows; and other providers of health care of the postmenopausal population. SOCIAL MEDIA ABSTRACT:Postmenopausal women often have a thickening of the lining of the uterus found during ultrasound. Without bleeding, an endometrium <11 mm is rarely a serious problem but should be evaluated by a health care provider. SUMMARY STATEMENTS:RECOMMENDATIONS.
10.1016/j.jogc.2024.102591
Clinicopathologic characteristics and risk factors for endometrial malignancy in postmenopausal women with endometrial thickening.
Menopause (New York, N.Y.)
OBJECTIVE:To evaluate the clinicopathological characteristics and risk factors for endometrial malignancy in postmenopausal women with endometrial thickening. METHODS:This was a retrospective study. Postmenopausal women with endometrial thickening (defined as the thickest endometrial portion in the sagittal uterine plane was greater than or equal to 5 mm) through transvaginal ultrasound in our outpatient department, and further referred to the gynecology department at Xuanwu Hospital for hysteroscopic diagnostic curettage assessment between January 2018 and March 2021 were included. According to the histopathological results, participants were divided into the benign group and malignant group. Univariate analysis was used to compare the differences in various factors, including demographics, clinical characteristics, medical complications, and ultrasound characteristics, between the two groups. Multiple logistic regression analysis was used to identify the factors that were independent contributors to the development of endometrial malignancy. Receiver operating characteristic analysis of endometrial thickness (ET) to predict endometrial malignancy was performed. RESULTS:In total, 385 eligible cases were included in the analysis. The results suggested that older age (odds ratio [OR] 1.061, 95% confidence interval [CI] 1.008-1.116, P = 0.023), thicker ET (OR 5.032, 95% CI 2.453-10.322, P < 0.001), irregular menstruation in the past (OR 19.203, 95% CI 1.936-190.431, P = 0.012), postmenopausal bleeding (OR 12.341, 95% CI 4.440-34.302, P < 0.001), and polypoid mass-like lesions (OR 30.330, 95% CI 8.974-102.509, P < 0.001) were risk factors that were independently associated with the development of endometrial malignancy in postmenopausal women with increased ET. The optimal critical value of ET in predicting malignancy was 9.5 mm, and the sensitivity and specificity were 71.70% and 71.69%, respectively. CONCLUSIONS:For postmenopausal women with endometrial thickening, our results suggested that women who are older, have a thicker ET, had irregular menstruation in the past, have postmenopausal bleeding, and have polypoid mass-like lesions should seek medical attention as soon as possible and undergo further invasive examination. The use of 9.5 mm as the ET value to prompt investigations may be acceptable since it is unlikely to miss any atypical endometrial hyperplasia or endometrial cancer.
10.1097/GME.0000000000001903
Analysis of factors related to endometrial cancer in postmenopausal women with endometrial thickening.
Menopause (New York, N.Y.)
OBJECTIVE:To investigate the factors related to endometrial cancer (EC) in postmenopausal women with endometrial thickening and the value of endometrial thickness (ET) in predicting EC. METHODS:A retrospective study of 385 referrals to our department for hysteroscopic diagnostic curettage assessment was carried out. Univariate analysis and multiple logistic regression analysis were used to identify the independent contributors to the development of EC. The ability of ET to predict EC was evaluated by receiver operating characteristic curve analysis. RESULTS:The follow-up period from the identification of endometrial thickening to pathological confirmation of EC was from 2 weeks to 3 months. In the postmenopausal bleeding (PMB) group, a total of 47 participants' specimens were pathologically malignant. Older age and polypoid mass-like lesions ( P < 0.001) were independent factors associated with EC. The optimal critical value of ET in predicting EC was 9.5 mm, with a sensitivity and specificity of 70.21% and 70.67%, respectively. In the non-PMB group, six participants had evidence of malignant pathology, and only polypoid mass-like lesions were an independent factor associated with EC ( P < 0.001). CONCLUSIONS:For postmenopausal women with increased ET and PMB, older age, thicker ET, and polypoid mass-like lesions on transvaginal ultrasound were independent associated factors for EC. An ET greater than 9.5 mm is a threshold for predicting EC. For postmenopausal women with increased ET without PMB, the incidence of endometrial malignancy is low. If the woman has polypoid mass-like lesions on transvaginal ultrasound, she should receive further attention.
10.1097/GME.0000000000002232
Hysteroscopic assessment of postmenopausal endometrial thickening.
Korkmazer Engin,Solak Neşe,Üstünyurt Emin
Przeglad menopauzalny = Menopause review
INTRODUCTION:Endometrial thickness is measured by transvaginal sonography and thickening indicates an increased risk of malignancy or other pathology (hyperplasia or polyp) in the postmenopausal period. The main screening methods for the uterine cavity are dilatation and curettage, and hysteroscopy. We sought to correlate hysteroscopic and pathological findings in asymptomatic postmenopausal women with sonographically thickened endometrium (> 5 mm) in this study. MATERIAL AND METHODS:This retrospective cross-sectional study involved case records of 197 women who have thickened (> 5 mm) endometrium in the postmenopausal period. All these women underwent hysteroscopy with diagnostic dilatation and curettage between January 2012 and January 2013 at the Bursa Zübeyde Hanım Maternity Hospital. Sensitivity, specificity, positive, negative predictive values and p value of hysteroscopy were calculated. Dilatation and curettage was set as the gold standard. RESULTS:For the evaluation of postmenopausal thickened endometrium, hysteroscopy revealed sensitivity, specificity, positive predictive value and negative predictive value as 76.4%, 76.9%, 73.1%, 79.8%, respectively. CONCLUSIONS:Hysteroscopy is a fast and accurate technique in evaluation of the intrauterine space occupying lesions (polyp, fibroid) but only moderate for endometrial hyperplasia. Hysteroscopic view combined with direct biopsy could be a gold standard for endometrial assessment.
10.5114/pm.2014.47985
Asymptomatic endometrial thickening in postmenopausal women: predictor of malignant pathology?
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
It is not standardised what is the endometrial thickness that discriminates between normal and potentially malignant. The objective of this study was to determine the endometrial thickness cut-off point from which the risk of endometrial cancer (EC) increases in asymptomatic postmenopausal women; and to evaluate the risk factors linked to malignant endometrial pathology as well as other associated ultrasound findings.This was a retrospective observational study that included hysteroscopies performed at the Hospital Materno-Infantil on 267 asymptomatic menopausal women with an increase in endometrial thickness (AET) >5 mm, from 2015 to 2019. The results shows that the prevalence of malignant pathology in asymptomatic postmenopausal women with a casual finding of endometrial thickening was 3.7%. This percentage was 16.3% when the cut-off point of AET was established at 10 mm. There was a significant association for the diagnosis of malignant pathology with this cut-off point.There is a significant association between the 10 mm endometrial thickness cut-off point from which the risk of EC increases in asymptomatic postmenopausal women.Impact statement Several studies have established the cut-off point for asymptomatic endometrial thickening (AET) for atypical endometrial hyperplasia and endometrial cancer at 10 mm. Although no cut-off point has optimal accuracy for the diagnosis of malignant endometrial pathology, it has been found that with a cut-off value of AET >10 mm no cases are missed. Likewise, a cut-off point of AET > 11 mm may provide a balance between cancer detection and histopathological workup extension. A significant association was found at the cut-off point of AET > 10 mm, which suggests that screening postmenopausal women at this thickness is acceptable and unlikely to miss cases of endometrial hyperplasia and endometrial cancer. After analysing our results we can conclude, like other published studies, that by establishing a cut-off point of 10 mm we obtain a good discrimination between benign and malignant pathology, which would allow us to diagnose 100% of malignant pathology. Above this cut-off point, the risk of endometrial cancer increases, and it would therefore be advisable to extend the study. A multicentre study is needed to confirm the cut-off point at which the risk of endometrial cancer increases in postmenopausal women with asymptomatic endometrial thickening.
10.1080/01443615.2022.2160928