title: Endometrial histology in severely obese bariatric surgery candidates: an exploratory analysis.
abstract: BACKGROUND
  Endometrial pathology risk has been linked to obesity; however, little is known of its prevalence in severely obese women not seeking care for endometrial pathology associated symptoms. This pilot study was designed to explore the frequency and risk factors associated with endometrial pathology in cancer-free, severely obese, bariatric surgery candidates using the Pipelle endometrial sampling technique (SureFlex Preferred Curette, Bioteque America, Inc, New Taipei City, Taiwan).
  
  
  METHODS
  Twenty-nine severely obese bariatric surgery candidates with intact uteruses and no history of endometrial cancer or endometrial ablation were included in this subanalysis from a larger cohort of 47. Endometrial samples were obtained using a Pipelle endometrial suction curette at a single time point before surgery. Logistic regression was used to assess the relationship between body mass index and endometrial pathology when adjusting for age and race.
  
  
  RESULTS
  Of the 29 successful biopsies, 8 (27.6%) were classified as abnormal endometrium: 1 was classified as complex atypical hyperplasia, 1 was classified as hyperplasia without atypia, 4 samples were identified with endometrial polyps, and 2 samples were identified with metaplasia. None presented with cancer. Increasing body mass index was significantly associated with higher risk of abnormal endometrium (OR = 1.19, 95% CI [1.03-1.36], P = .01).
  
  
  CONCLUSIONS
  The findings in this sample suggest that obesity may be associated with increased risk of having undiagnosed endometrial pathology. More thorough examination of relationships between levels of obesity and endometrial pathology are needed to better characterize high cancer risk groups who may benefit from introducing new screening measures.
authors.affiliation: Center for Life Sciences, Nazarbayev University, Astana, Kazakhstan.
authors.forename: Aiym
authors.initials: A
authors.lastname: Kaiyrlykyzy
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Kyle E
authors.initials: KE
authors.lastname: Freese
authors.affiliation: Department of Pathology, Magee-Womens Hospital, Pittsburgh, PA.
authors.forename: Esther
authors.initials: E
authors.lastname: Elishaev
authors.affiliation: University of Pittsburgh Cancer Institute, Pittsburgh, PA.
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.affiliation: Division of General Surgery, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Ramanathan
authors.affiliation: Division of General Surgery, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Giselle G
authors.initials: GG
authors.lastname: Hamad
authors.affiliation: Division of General Surgery, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA.
authors.forename: Carol
authors.initials: C
authors.lastname: McCloskey
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Althouse
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Edwards
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Department of Obstetrics, Gynecology & Reproductive Sciences, Magee-Womens Research Institute, Pittsburgh, PA. Electronic address: linkfy@mail.magee.edu.
authors.forename: Faina
authors.initials: F
authors.lastname: Linkov
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001706:Biopsy; D015992:Body Mass Index; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Bariatric surgery; Endometrial cancer; Endometrial hyperplasia; Endometrial polyps; Obesity; Pipelle sampling