Common Symptom Could Improve Endometrial Cancer Detection

Postmenopausal bleeding could play an important role in detecting endometrial cancer, as it is present in the vast majority of endometrial cancer cases, according to findings from a recent systematic review and meta-analysis.

“Early detection strategies focused on women with [postmenopausal bleeding] have the potential to capture as many as 90% of endometrial cancers,” the authors of the study wrote.

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For their review, Megan A Clarke, PhD, MHS, of the National Cancer Institute in Rockville, Maryland, and colleagues evaluated 129 unique studies (N = 40,790) of women with postmenopausal bleeding (n = 34,432) and women with endometrial cancer (n = 6358).

Studies included in the final analysis were published between January 1, 1977, and January 31, 2017. Data were obtained from PubMed and Embase.

Ultimately, the researchers found that postmenopausal bleeding occurred in 91% of women with endometrial cancer, regardless of tumor stage. This finding could have important implications for endometrial cancer detection in the future, they said.

“These results can aid in the assessment of the potential clinical value of new early detection markers and clinical management strategies for endometrial cancer and will help to inform clinical and epidemiologic risk prediction models to support decision making,” Dr Clarke and colleagues wrote.

“[H]owever,” the authors noted, “most women with [postmenopausal bleeding] will not be diagnosed with endometrial cancer.”

In this cohort, the pooled risk for endometrial cancer among women with postmenopausal bleeding was 9%. Estimates varied based on the use of hormone therapy (7% to 12%) and geographic region (5% in North America to 13% in Western Europe).

—Christina Vogt

Reference:

Clarke MA, Long BJ, Del Mar Morillo A, et al. Association of endometrial cancer risk with postmenopausal bleeding in women: a systematic review and meta-analysis [Published online August 6, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.2820