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Risk assessment for endometrial cancer in women with abnormal vaginal bleeding: Results from the prospective IETA‐1 cohort study
Author(s) -
Verbakel Jan Yvan,
Heremans Ruben,
Wynants Laure,
Epstein Elisabeth,
De Cock Bavo,
Pascual Maria Angela,
Leone Francesco Paolo Giuseppe,
Sladkevicius Povilas,
Alcazar Juan Luis,
Van Pachterbeke Catherine,
Jokubkiene Ligita,
Fruscio Robert,
Bourne Tom,
Van Calster Ben,
Timmerman Dirk,
Van den Bosch Thierry
Publication year - 2022
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.14097
Subject(s) - medicine , endometrial cancer , body mass index , obstetrics , gynecology , prospective cohort study , menopause , cancer
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), R 2 , 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.