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Risk assessment for endometrial cancer in women with abnormal vaginal bleeding : Results from the prospective IETA-1 cohort study

Verbakel, Jan Yvan ; Heremans, Ruben ; Wynants, Laure ; Epstein, Elisabeth LU ; De Cock, Bavo ; Pascual, Maria Angela ; Leone, Francesco Paolo Giuseppe ; Sladkevicius, Povilas LU orcid ; Alcazar, Juan Luis and Van Pachterbeke, Catherine , et al. (2022) In International Journal of Gynecology and Obstetrics 159(1). p.103-110
Abstract

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,... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endometrial neoplasms, endometrium, uterine hemorrhage
in
International Journal of Gynecology and Obstetrics
volume
159
issue
1
pages
103 - 110
publisher
Wiley-Blackwell
external identifiers
  • scopus:85125067603
  • pmid:35044676
ISSN
0020-7292
DOI
10.1002/ijgo.14097
language
English
LU publication?
yes
id
48c03f7f-e740-4745-99ae-d7314b4ef31c
date added to LUP
2022-04-19 11:04:58
date last changed
2024-11-18 11:02:54
@article{48c03f7f-e740-4745-99ae-d7314b4ef31c,
  abstract     = {{<p>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<sup>2</sup>, 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.</p>}},
  author       = {{Verbakel, Jan Yvan and Heremans, Ruben and Wynants, Laure and Epstein, Elisabeth and De Cock, Bavo and Pascual, Maria Angela and Leone, Francesco Paolo Giuseppe and Sladkevicius, Povilas and Alcazar, Juan Luis and Van Pachterbeke, Catherine and Jokubkiene, Ligita and Fruscio, Robert and Bourne, Tom and Van Calster, Ben and Timmerman, Dirk and Van den Bosch, Thierry}},
  issn         = {{0020-7292}},
  keywords     = {{endometrial neoplasms; endometrium; uterine hemorrhage}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{103--110}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{International Journal of Gynecology and Obstetrics}},
  title        = {{Risk assessment for endometrial cancer in women with abnormal vaginal bleeding : Results from the prospective IETA-1 cohort study}},
  url          = {{http://dx.doi.org/10.1002/ijgo.14097}},
  doi          = {{10.1002/ijgo.14097}},
  volume       = {{159}},
  year         = {{2022}},
}