title: How often are endometrial polyps malignant in asymptomatic postmenopausal women? A multicenter study.
abstract: OBJECTIVE
  The objective of the study was to evaluate the prevalence of cancer and premalignant lesions in polyps on atrophic endometrium in asymptomatic postmenopausal women to compare these findings with a similar cohort of patients with abnormal uterine bleeding.
  
  
  METHODS
  One thousand one hundred fifty-two asymptomatic and 770 consecutive postmenopausal women with abnormal uterine bleeding were included in a retrospective multicenter study. Recruited patients underwent hysteroscopic polypectomy based on a sonohysterographic or hysteroscopic diagnosis. The pathologic report was the main outcome measure.
  
  
  RESULTS
  One single case of stage 1 grade 1 endometrial carcinoma on a polyp with a mean diameter of 40 mm (0.1%) was observed in asymptomatic women. This prevalence was 10 times lower than in symptomatic patients (P < .0001). The prevalence of atypical hyperplastic polyps was 1.2% in asymptomatic women (2.2% in symptomatic patients; P < .005). At multivariate analysis, polyps' diameter was the only variable significantly associated to an abnormal histology (cancer, polypoid cancer, and atypical hyperplasia) in asymptomatic women (odds ratio for polyps with mean diameter > 18 mm, 6.9; confidence interval, 2.2-21.4).
  
  
  CONCLUSIONS
  Follow-up and/or treatment of endometrial polyps incidentally diagnosed in asymptomatic postmenopausal patients could be safely restricted to few selected cases based on polyp diameter.
authors.affiliation: Department of Obstetrics and Gynecology, DSC L. Sacco, University of Milan, Milan, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrazzi
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Leone
authors.forename: Luca
authors.initials: L
authors.lastname: Savelli
authors.forename: Umberto
authors.initials: U
authors.lastname: Omodei
authors.forename: Massimo
authors.initials: M
authors.lastname: Moscarini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Barbieri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cammareri
authors.forename: Giampiero
authors.initials: G
authors.lastname: Capobianco
authors.forename: Ettore
authors.initials: E
authors.lastname: Cicinelli
authors.forename: Maria E
authors.initials: ME
authors.lastname: Coccia
authors.forename: Gloria
authors.initials: G
authors.lastname: Donarini
authors.forename: Simona
authors.initials: S
authors.lastname: Fiore
authors.forename: Paolo
authors.initials: P
authors.lastname: Litta
authors.forename: Mario
authors.initials: M
authors.lastname: Sideri
authors.forename: Eugenio
authors.initials: E
authors.lastname: Solima
authors.forename: Donata
authors.initials: D
authors.lastname: Spazzini
authors.forename: Antonia C
authors.initials: AC
authors.lastname: Testa
authors.forename: Massimo
authors.initials: M
authors.lastname: Vignali
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D000368:Aged; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia; D015907:Hysteroscopy; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D011127:Polyps / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D017698:Postmenopause; D011230:Precancerous Conditions / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D015995:Prevalence; D012189:Retrospective Studies