Is endometrial ablation protective against endometrial cancer? A retrospective observational study.
OBJECTIVE
Endometrial ablation has been increasingly used over the last 30 years to manage patients with dysfunctional uterine bleeding. Of primary concern, however, is the potential of the procedure to mask the presence or delay the diagnosis of endometrial cancer. The aim of this study is to assess the long-term effects of endometrial ablation and its association with the development of endometrial cancer.


METHODS
This is a retrospective observational study that was conducted at Bradford Teaching Hospitals in the United Kingdom. The study included all women who had different types of endometrial ablative procedures in the period of January 1994 to December 2011. Analysis of the data was performed using SPSS for windows (V9) software package.


RESULTS
Over 18 years period, 1521 women had endometrial ablative procedures for dysfunctional uterine bleeding. During their long-term follow-up, none of the women developed endometrial cancer later in life. This incidence is much lower than the lifetime risk of endometrial cancer in the general population (RR 0.0135; 95 % CI 0.0007-0.2801; P = 0.0054).


CONCLUSIONS
To our knowledge, this is the largest study to examine the long-term incidence of endometrial cancer in women who had endometrial ablative procedures. It shows that the development of endometrial cancer does not seem to be associated with endometrial ablative procedures.
Department of Obstetrics and Gynaecology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, Yorkshire, UK.
M
M
Singh
Department of Obstetrics and Gynaecology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, Yorkshire, UK. magedlap@yahoo.com.|Ain Shams University, Abbassia Square, Cairo, Egypt. magedlap@yahoo.com.
Mohamed M
MM
Hosni
Department of Obstetrics and Gynaecology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, Yorkshire, UK.
S E
SE
Jones
D000328:Adult; D055356:Endometrial Ablation Techniques; D004714:Endometrial Hyperplasia / Q000150:complications; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008796:Metrorrhagia / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
Dysfunctional uterine bleeding; Endometrial ablation; Endometrial cancer; Postmenopausal women