title: Predictors of malignancy in endometrial polyps: a multi-institutional cohort study.
abstract: OBJECTIVE
  The risk of endometrial cancer in women with endometrial polyps (EPs) has been reported to vary between 0.3% and 4.8%. There is a lack of data about the management of asymptomatic women with incidental diagnosis of EPs. In the present study the authors correlated demographic and clinical characteristics with histopathological features of the EPs hysteroscopically removed.
  
  
  METHODS
  An observational multi-institutional cohort study was conducted from February 2010 to December 2012 to identify all the premenopausal and postmenopausal women consecutively undergoing hysteroscopic polypectomy. The data of women were reviewed and clinical features were related to histopathologic results.
  
  
  RESULTS
  The patients recruited were 813. The mean age was 52.5 years (range 22-87). The results showed a correlation between older age, high body mass index (BMI) and obesity, postmenopausal state, abnormal uterine bleeding (AUB), hypertension, and risk of malignant EPs. On multivariable analysis, the correlation remained only for age (OR 1.08, 95% CI 1.03 - 1.14) and AUB (OR 3.53, 95% CI 1.87 - 6.65).
  
  
  CONCLUSIONS
  Older patients in postmenopausal status with AUB, a high BMI, and hypertension are at higher risk for premalignant and malignant polyps. In these patients a surgical approach should be used, consisting in hysteroscopical removing of the polyp.
authors.forename: P
authors.initials: P
authors.lastname: Litta
authors.forename: J
authors.initials: J
authors.lastname: Di Giuseppe
authors.forename: L
authors.initials: L
authors.lastname: Moriconi
authors.forename: G
authors.initials: G
authors.lastname: Delli Carpini
authors.forename: M G
authors.initials: MG
authors.lastname: Piermartiri
authors.forename: A
authors.initials: A
authors.lastname: Ciavattini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015331:Cohort Studies; D004714:Endometrial Hyperplasia / Q000150:complications / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D015907:Hysteroscopy; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D011127:Polyps / Q000150:complications / Q000473:pathology*; D017698:Postmenopause; D011230:Precancerous Conditions / Q000150:complications / Q000473:pathology*; D017697:Premenopause; D012307:Risk Factors; D014591:Uterine Diseases / Q000150:complications / Q000473:pathology; D014592:Uterine Hemorrhage / Q000150:complications; D055815:Young Adult