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Hysteroscopic chasing for endometrial cancer in a low-risk population: risks of overinvestigation

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the appropriateness of the indications for hysteroscopy done, in fertile and postmenopausal women, for the detection of endometrial cancer.

Methods

A retrospective analysis of 2673 consecutive women who underwent office hysteroscopy chasing for endometrial cancer between January 2012 and June 2014. According to their medical history only low-risk women entered the study.

Results

A total of 1070 patients entered the study. The main outcome measure was the appropriateness of the indications for hysteroscopy. Appropriateness was assessed on the basis of guidelines of scientific societies and histologic report. According to the algorithm developed for appropriateness, 44 % of procedures resulted in being inappropriate. In reproductive-aged women 57 % of hysteroscopies were inappropriate. In postmenopausal women inappropriate hysteroscopies were 45 %. In reproductive-aged women, the reasons for inappropriateness were: absence of abnormal uterine bleeding (AUB) or AUB without a trial of progestin therapy. In postmenopausal women, the reasons for inappropriateness were: ultrasound report of endometrial thickening or polyp without bleeding.

Conclusions

Hysteroscopy is often recommended for inappropriate indications. More evidence is needed to identify the risks of overinvestigation, overdiagnosis, and related overtreatment and to better identify the threshold beyond which benefits are likely to outweigh harms.

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Authors and Affiliations

  1. Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Via dell’Istria 65/1, 34137, Trieste, Italy

    Federica Scrimin, Uri Wiesenfeld, Emanuele F. Galati, Lorenzo Monasta & Giuseppe Ricci

  2. University of Trieste, Trieste, Italy

    Emanuele F. Galati & Giuseppe Ricci

Authors
  1. Federica Scrimin
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  2. Uri Wiesenfeld
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  3. Emanuele F. Galati
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  4. Lorenzo Monasta
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  5. Giuseppe Ricci
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Correspondence to Uri Wiesenfeld.

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The authors report no conflict of interest.

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Scrimin, F., Wiesenfeld, U., Galati, E.F. et al. Hysteroscopic chasing for endometrial cancer in a low-risk population: risks of overinvestigation. Arch Gynecol Obstet 293, 851–856 (2016). https://doi.org/10.1007/s00404-015-3868-x

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  • DOI: https://doi.org/10.1007/s00404-015-3868-x

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