title: Risk factors for developing endometrial cancer after benign endometrial sampling.
abstract: OBJECTIVE
  To identify risk factors for endometrial cancer after benign results of endometrial biopsy or dilation and curettage (D&C).
  
  
  METHODS
  Nested case-control study from Rochester Epidemiology Project data. Among 370 Olmsted County, Minnesota, residents who received an endometrial cancer diagnosis between 1970 and 2008, we identified 90 patients (24.5%) who had previous benign endometrial biopsy or D&C results (no atypical hyperplasia). We compared them with 172 matched control group participants who had benign endometrial biopsy or D&C results without subsequent endometrial cancer.
  
  
  RESULTS
  Using a multivariable conditional logistic regression model, we found that oral contraceptive pill (OCP) use was protective (odds ratio [OR] 0.18, 95% CI [CI] 0.08-0.45; P<.001), and personal history of colorectal cancer (OR 4.44, 95% CI 1.02-19.31; P<.05), endometrial polyp (OR 4.12, 95% CI 1.40-12.17; P=.01), and morbid obesity (OR 3.40, 95% CI 1.18-9.78; P<.03) were independently associated with subsequent endometrial cancer. Compared with the presence of no risk factor, presence of one and two or more risk factors increased the risk of endometrial cancer by 8.12 (95% CI 3.08-21.44) and 17.87 (95% CI 5.57-57.39) times, respectively. Assuming a 2.6% lifetime risk of endometrial cancer, ORs of 8.12 and 17.87 for one and two or more of the four aforementioned risk factors confer a lifetime risk of approximately 18% and 32%, respectively.
  
  
  CONCLUSIONS
  One fourth of patients with endometrial cancer had previous benign endometrial biopsy or D&C results. Personal history of colorectal cancer, presence of endometrial polyps, and morbid obesity are the strongest risk factors for having endometrial cancer after a benign endometrial biopsy or D&C result, and OCP use is the strongest protective factor.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics and Gynecology and the Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Torres
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kumar
authors.forename: Stefano
authors.initials: S
authors.lastname: Uccella
authors.forename: Abimbola O
authors.initials: AO
authors.lastname: Famuyide
authors.forename: William A
authors.initials: WA
authors.lastname: Cliby
authors.forename: Sean C
authors.initials: SC
authors.lastname: Dowdy
authors.forename: Bobbie S
authors.initials: BS
authors.lastname: Gostout
authors.forename: Andrea
authors.initials: A
authors.lastname: Mariani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016022:Case-Control Studies; D004107:Dilatation and Curettage; D016889:Endometrial Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011127:Polyps / Q000473:pathology; D011230:Precancerous Conditions / Q000473:pathology; D012307:Risk Factors; D055815:Young Adult