Publicaciones científicas
Risk assessment for endometrial cancer in women with abnormal vaginal bleeding: results from the prospective IETA-1 cohort study
Jan Yvan Verbakel 1 2 , Heremans Ruben 3 4 , Wynants Laure 3 5 , Epstein Elisabeth 6 , De Cock Bavo 3 , Pascual Maria Angela 7 , Leone Francesco Paolo Giuseppe 8 , Sladkevicius Povilas 9 , Alcazar Juan Luis 10 , Van Pachterbeke Catherine 11 , Jokubkiene Ligita 9 , Fruscio Robert 12 , Bourne Tom 3 13 , Van Calster Ben 3 14 , Timmerman Dirk 3 4 , Van den Bosch Thierry 3 4 , IETA consortium
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, i.e. age, body mass index (BMI) and nulliparity were defined a priori for baseline risk assessment of endometrial malignancy.
Following variables were tested for added value: intra-uterine 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 squared, and Akaike's Information Criterion.
Results: Of 2417 women, 155 (6%) had endometrial malignancy or endometrial intraepithelial neoplasia. In women with endometrial cancer median (interquartile range) age was 67 years (56-75), median parity was 2 (0-10) and median BMI was 28 kg/m² (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.
Conclusions: Age, parity and BMI help assess endometrial cancer risk in women with abnormal uterine bleeding. Other patient information adds little, whereas sonographic endometrial thickness substantially improves assessment.
CITA DEL ARTÍCULO Int J Gynaecol Obstet. 2022 Oct;159(1):103-110. doi: 10.1002/ijgo.14097. Epub 2022 Feb 7.