Prevalence of endometrial cancer in symptamatic women with thickened endometrium OPTIONAL LOGO HERE OPTIONAL LOGO HERE Dr Maheswari SRINIVASAN MRCOG SpR, Mrs Shagaf BAKOUR FRCOG Consultant Obs & Gynae. City Hospitals, Sandwell and West Birmingham NHS trust, Birmingham Methods Objectives Back ground• Endometrial cancers are the most common gynaecologic cancers. Materials and Methods:• Post menopausal clinics are in operation in our trust. • Retrospective review of the case notes of women who attended with symptoms of post menopausal bleeding over 3 • Incidence of endometrial cancer is on the rise due to increase in obesity in the world. • Endometrial cancer predominantly occurs in the perimenopusal and post menopausal women with thickened endometrium. • Risk factors include postmenopausal oestrogen therapy, obesity, a high-fat diet, reproductive factors like nulliparity, early menarche and late menopause, polycystic ovarian syndrome, and tamoxifen use year period from Jan 2008 until Dec 2010. • There were 56 clinics • 262 women attended. • 101 women had thickened endometrium ET > 4 mm. • Endometrial pipelle samples and further investigations were carried out in these women. • 262 patients were identified and analysed. • All women with symptoms of post menopausal bleeding • .16 patients were on Tamoxifen. underwent transvaginal scanning. • Women with thickened endometrium of more than 4mm underwent endometrial pipelle biopsy. • The number of women diagnosed with endometrial cancer underwent surgical management in the form of total have endometrial carcinoma. • The main objective of the diagnostic evaluation of women with • Age range-47-91 yrs Conclusions • 10% of women with thickened endometrium turned out to have endometrial cancer this correlates to the international observational studies. • 56% of women with suspected endometrial polyps were confirmed by hysteroscopy. • None of the women with endometrial thickness less than 4 mm found to have carcinoma. • Ten women were diagnosed with endometrial cancer (10% incidence). • Three had cervical cancer. • Seven women were diagnosed with complex hyperplasia abdominal hysterectomy and bilateral salphingo in the initial pipelle sample, of which endometrial cancer oophorectomy. was present in 4 women. • 21 patient had sonographic findings suggestive of postmenopausal vaginal bleeding is exclusion of malignancy. postmenopausal women with vaginal bleeding. • 56 clinics • 13 patients were HRT users • 10% of symptomatic women with thickened endometrium will • Transvaginal ultrasound is a cost-minimizing screening tool for Results … endometrial polyp of which 12 confirmed by the gold standard (hysteroscopy) (57%) • Endometrial polyps are often diagnosed with transvaginal ultrasonography while in some occasions it might be bit difficult. • Saline sonography helps in the better detection of endometrial polyps. References Aim • To ascertain the pick up rate of endometrial cancer in women attended the Post Menopausal Bleeding clinic with Postmenopausal bleeding and thickened endometrium. • To ascertain the prevalence of other pathology (polyps) in the same cohort of women TEMPLATE DESIGN © 2008 www.PosterPresentations.com • Ultrasonographic evaluation of the endometrium in postmenopausal vaginal bleeding-Davidson KG, Dubinsky TJ.Department of Anesthesiology, University of Iowa Hospitals and Clinics, 6 JCP, Iowa City IA 52242, USA. Radiol Clin North Am. 2003 Jul;41(4):769-80 • Transvaginal sonography combined with saline contrast sonohysterography to evaluate the uterine cavity in patients with abnormal uterine bleeding and postmenopausal endometrium more than 5 mm. Kazandi M, Akşehirli S, Cirpan T, Akercan F. Eur J Gynaecol Oncol. 2003; 24(2):185-90. • Endometrial polyps in postmenopausal women. • Domingues AP, Lopes H, Dias I, De Oliveira CF. Acta Obstet Gynecol Scand. 2009; 88(5):618-20. …