Use of ultrasonographic cut point for diagnosing endometrial pathology in postmenopausal women with multiple risk factors for endometrial cancer.
OBJECTIVE
To determine if the established endometrial thickness cut point (5 mm) for abnormal endometrial pathology shifts to higher thickness in the presence of selected risk factors/comorbidities.


METHODS
A sample of 112 postmenopausal women was identified. The outcome was abnormal endometrial pathology, be it endometrial cancer or hyperplasia with atypia. Logistic regression was used to calculate prevalence odds ratios (ORs) of abnormal results for women with thick or thin endometria and 0 or > or = 1 of the following comorbidities/cofactors: obesity, diabetes, hypertension and use of hormone replacement therapy.


RESULTS
Approximately half the sample was hypertensive; 56.3% were obese. A large proportion (84.8%) of the patients had > or = 1 of the comorbidities/cofactors of interest. Women with endometria > or = 12 mm and > or = 1 comorbidities appeared to have 5 times the odds of having an abnormal result compared to women with thin endometria (<12 mm) who had 0 comorbidities; this result was not statistically significant (adjusted OR = 5.08, p = 0.07). A dose-response curve (regression spline) showed that the prevalence of an abnormal outcome increased sharply between 5 and 9 mm.


CONCLUSIONS
Clinicians should continue to use the 5-mm cut point when deciding whether patients should have endometrial sampling.
Nutis
Mario
M
Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, El Paso, Texas 79905, USA.
García
K Michelle
KM
Nuwayhid
Bahij
B
Mulla
Zuber
Z
ElMasri
Wafic
W
D000368:Aged; D015897:Comorbidity; D048909:Diabetes Complications; D004714:Endometrial Hyperplasia / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology; D016015:Logistic Models; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000473:pathology; D016017:Odds Ratio; D017698:Postmenopause; D015995:Prevalence; D012016:Reference Values; D015203:Reproducibility of Results; D012307:Risk Factors; D014463:Ultrasonography / Q000592:standards*