TY - JOUR
T1 - Risk assessment for endometrial cancer in women with abnormal vaginal bleeding
T2 - Results from the prospective IETA-1 cohort study
AU - Verbakel, Jan Yvan
AU - Heremans, Ruben
AU - Wynants, Laure
AU - Epstein, Elisabeth
AU - De Cock, Bavo
AU - Pascual, Maria Angela
AU - Leone, Francesco Paolo Giuseppe
AU - Sladkevicius, Povilas
AU - Alcazar, Juan Luis
AU - Van Pachterbeke, Catherine
AU - Jokubkiene, Ligita
AU - Fruscio, Robert
AU - Bourne, Tom
AU - Van Calster, Ben
AU - Timmerman, Dirk
AU - Van den Bosch, Thierry
AU - IETA consortium
N1 - © 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.
PY - 2022/10
Y1 - 2022/10
N2 - 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-age, body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters), and nulliparity-were defined a priori for baseline risk assessment of endometrial malignancy. The following variables were tested for added value: intrauterine 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), R2 , and Akaike's information criterion.RESULTS: Of 2417 women, 155 (6%) had endometrial malignancy or endometrial intraepithelial neoplasia. In women with endometrial cancer median age was 67 years (interquartile range [IQR] 56-75 years), median parity was 2 (IQR 0-10), and median BMI was 28 (IQR 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.CONCLUSION: Age, parity, and BMI help in the assessment of endometrial cancer risk in women with abnormal uterine bleeding. Other patient information adds little, whereas sonographic endometrial thickness substantially improves assessment.
AB - 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-age, body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters), and nulliparity-were defined a priori for baseline risk assessment of endometrial malignancy. The following variables were tested for added value: intrauterine 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), R2 , and Akaike's information criterion.RESULTS: Of 2417 women, 155 (6%) had endometrial malignancy or endometrial intraepithelial neoplasia. In women with endometrial cancer median age was 67 years (interquartile range [IQR] 56-75 years), median parity was 2 (IQR 0-10), and median BMI was 28 (IQR 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.CONCLUSION: Age, parity, and BMI help in the assessment of endometrial cancer risk in women with abnormal uterine bleeding. Other patient information adds little, whereas sonographic endometrial thickness substantially improves assessment.
KW - ACCURACY
KW - FAMILY-HISTORY
KW - METAANALYSIS
KW - endometrial neoplasms
KW - endometrium
KW - uterine hemorrhage
U2 - 10.1002/ijgo.14097
DO - 10.1002/ijgo.14097
M3 - Article
C2 - 35044676
SN - 0020-7292
VL - 159
SP - 103
EP - 110
JO - International Journal of Gynecology & Obstetrics
JF - International Journal of Gynecology & Obstetrics
IS - 1
ER -