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ObjectiveTo determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women.MethodsThis retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged  25 kg/m2 (odds ratio [OR], 4.4705), age &gt;40 years (OR, 1.14), endometrial thickness (ET) &gt;13 mm (OR, 2.59), and hypothyroidism (OR, 1.35) were significantly associated with EH/ EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables.ConclusionThe risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged &gt;40 years, hypothyroidism, BMI &gt;25 kg/m2, and thickened endometrium (ET &gt;13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.

Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy