title: Endometrial Cancer Associated Symptoms: A Case-Control Study.
abstract: The majority of women with endometrial cancer (EC) present at an early stage with an associated 5-year survival rate of >90%. High rates of early detection are attributed to warning symptoms; however, the prevalence of such symptoms has not been well defined.
  
  
  
  A case-control study was conducted assessing the prevalence of symptoms in EC patients at a large cancer center compared with healthy controls. Controls included patients seen for an annual gynecologic care visit (AV) or for a gynecological problem-based visit (PV). A self-administered questionnaire was given to all participants addressing EC-associated symptoms, at the time of initial clinic visit. Odds ratios (ORs) were used to compare prevalence of symptoms between EC cases and controls. Logistic regression was used to determine the impact of menopausal status and obesity on symptom prevalence.
  
  
  
  The cases (n = 75) were significantly older than the AV (n = 203) and PV (n = 151) controls (59.7 vs. 49.8 vs. 51.0 years, p < 0.01), had a higher body mass index (35.5 vs. 29.4 vs. 30.9 kg/m2, p < 0.01), and were more likely to be postmenopausal (76% vs. 53.7% vs. 52.0%, p < 0.01). The cases were more likely to report postmenopausal bleeding (OR = 32.99 and 5.83, p < 0.01) and abnormal vaginal discharge (OR = 8.8 and 3.3, p < 0.01) compared with the AV and PV groups. Overall, 55.4% of cases reported abnormal vaginal discharge.
  
  
  
  Symptoms of both postmenopausal bleeding and abnormal vaginal discharge were significantly higher in EC compared with controls. The presence of such symptoms should raise concern for malignant disease and prompt immediate gynecological evaluation.
authors.affiliation: 1 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Janelle B
authors.initials: JB
authors.lastname: Pakish
authors.affiliation: 1 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Lu
authors.affiliation: 1 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Charlotte C
authors.initials: CC
authors.lastname: Sun
authors.affiliation: 1 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Burzawa
authors.affiliation: 2 Kelsey Research Foundation , Houston, Texas.
authors.forename: Anthony
authors.initials: A
authors.lastname: Greisinger
authors.affiliation: 3 Kelsey-Seybold Clinic , Houston, Texas.
authors.forename: Frances A
authors.initials: FA
authors.lastname: Smith
authors.affiliation: 4 Department of Biostatistics, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Bryan
authors.initials: B
authors.lastname: Fellman
authors.affiliation: 4 Department of Biostatistics, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Urbauer
authors.affiliation: 1 Department of Gynecologic Oncology and Reproductive Medicine, University of Texas M.D. Anderson Cancer Center , Houston, Texas.
authors.forename: Pamela T
authors.initials: PT
authors.lastname: Soliman
mesh_terms: D016022:Case-Control Studies; D055088:Early Detection of Cancer / Q000379:methods*; D016889:Endometrial Neoplasms / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause; D011795:Surveys and Questionnaires; D013781:Texas; D014592:Uterine Hemorrhage / Q000209:etiology*; D019522:Vaginal Discharge / Q000209:etiology*
keywords: cancer symptoms; endometrial cancer; postmenopausal bleeding