Do postmenopausal women with thickened endometrium on trans-vaginal ultrasound in the absence of vaginal bleeding need hysteroscopic assessment? A Pilot Study

Abstract

We aimed to determine the incidence of endometrial cancer in a cohort of postmenopausal women with thickened endometrium but no bleeding referred for hysteroscopy and determine the risk estimate of cancer using a cut-off of > 11 mm. This retrospective study of asymptomatic postmenopausal women with thickened endometrium on trans-vaginal scan referred for hysteroscopy was performed using data from 2008 to 2010. In total 63 women were identified. 2 cases of endometrial cancer were identified with an incidence of 3.17%. 22 cases had endometrial thickness (ET) > 11 mm of which 2 were malignant giving a risk estimate for endometrial cancer of 9.1%. 61 women had benign pathology, 40.98% had atrophic endometrium and 59.02% had benign polyp. In conclusion, the incidence of endometrial cancer in postmenopausal women with thickened endometrium on transvaginal scan without vaginal bleeding is low and ET of 11 mm or more seems realistic to use as a cut-off for referral for hysteroscopy.

Keywords::

• Postmenopausal bleeding
• asymptomatic
• endometrial thickness
• endometrial cancer
• transvaginal ultrasound

Contribution to authorship

SEJ and RL contributed to the design and analysis of the study. RL and HB contributed to data collection and analysis. RL drafted and WD edited the initial manuscript for publication. SEJ contributed to project supervision, support, advice and editing. RL and HB contributed to statistical analysis; all authors approved its submission for publication.

Details of ethics approval

Not applicable

Funding

None to declare

Declaration of interests: We declare that we have no conflicts of interest