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Current strategies in the diagnosis of endometrial cancer

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Abstract

Purpose

Endometrial cancer is the most common gynecological malignancy in developed countries. There are no uniform recommendations for endometrial cancer screening in the general population. Therefore, it is of paramount importance that the primary physician profoundly understands, and is familiar with the methods for prevention and early detection of endometrial cancer. The aim of this review is to provide the primary physician with a toolbox to reach these goals.

Methods

We performed a systemic review to summarize the current strategies to diagnose and prevent endometrial cancer. Many published articles from the last years were identified and included.

Results

A systematic review that summarizes the important subjects in the diagnosis and prevention of endometrial cancer.

Conclusion

Maintaining a high index of suspicion and obtaining endometrial biopsies from all suspected patients is the key for achieving a timely diagnosis.

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References

  1. Committee A, ACOG Committee Opinion (2003) Routine cancer screening. Number 247, December 2000. Int J Gynaecol Obstet 82(2):241–245

    Article  Google Scholar 

  2. Smith RA, Cokkinides V (2005) Eyre HJ (2005) American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin 55(1):31–44 (quiz 55–56)

    Article  PubMed  Google Scholar 

  3. Jemal A et al (2011) Global cancer statistics. CA Cancer J Clin 61(2):69–90

    Article  PubMed  Google Scholar 

  4. Weiss NS, Szekely DR, Austin DF (1976) Increasing incidence of endometrial cancer in the United States. N Engl J Med 294(23):1259–1262

    Article  CAS  PubMed  Google Scholar 

  5. Ziel HK, Finkle WD (1975) Increased risk of endometrial carcinoma among users of conjugated estrogens. N Engl J Med 293(23):1167–1170

    Article  CAS  PubMed  Google Scholar 

  6. Smith DC et al (1975) Association of exogenous estrogen and endometrial carcinoma. N Engl J Med 293(23):1164–1167

    Article  CAS  PubMed  Google Scholar 

  7. Jick H, Walker AM, Rothman KJ (1980) The epidemic of endometrial cancer: a commentary. Am J Public Health 70(3):264–267

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Austin DF, Roe KM (1982) The decreasing incidence of endometrial cancer: public health implications. Am J Publ Health 72(1):65–68

    Article  CAS  Google Scholar 

  9. Jemal A et al (2010) Cancer statistics, 2010. CA Cancer J Clin 60(5):277–300

    Article  PubMed  Google Scholar 

  10. Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4(8):579–591

    Article  CAS  PubMed  Google Scholar 

  11. Lindemann K et al (2010) Endometrial cancer incidence trends in Norway during 1953-2007 and predictions for 2008-2027. Int J Cancer 127(11):2661–2668

    Article  CAS  PubMed  Google Scholar 

  12. Gao Y et al (2016) The prevalence of endometrial cancer in pre- and postmenopausal Chinese women. Menopause

  13. Jamison PM et al (2013) Trends in endometrial cancer incidence by race and histology with a correction for the prevalence of hysterectomy, SEER 1992–2008. Cancer Epidemiol Biomark Prev 22(2):233–241

    Article  Google Scholar 

  14. Amant F et al (2005) Endometrial cancer. Lancet 366(9484):491–505

    Article  PubMed  Google Scholar 

  15. Hill HA et al (1996) Racial differences in endometrial cancer survival: the black/white cancer survival study. Obstet Gynecol 88(6):919–926

    Article  CAS  PubMed  Google Scholar 

  16. Sonoda Y, Barakat RR (2006) Screening and the prevention of gynecologic cancer: endometrial cancer. Best Pract Res Clin Obstet Gynaecol 20(2):363–377

    Article  PubMed  Google Scholar 

  17. Brinton LA et al (2013) Etiologic heterogeneity in endometrial cancer: evidence from a Gynecologic Oncology Group trial. Gynecol Oncol 129(2):277–284

    Article  PubMed  PubMed Central  Google Scholar 

  18. Bokhman JV (1983) Two pathogenetic types of endometrial carcinoma. Gynecol Oncol 15(1):10–17

    Article  CAS  PubMed  Google Scholar 

  19. Setiawan VW et al (2013) Type I and II endometrial cancers: have they different risk factors? J Clin Oncol 31(20):2607–2618

    Article  PubMed  PubMed Central  Google Scholar 

  20. Moore KN, Fader AN (2011) Uterine papillary serous carcinoma. Clin Obstet Gynecol 54(2):278–291

    Article  PubMed  Google Scholar 

  21. Matias-Guiu X, Prat J (2013) Molecular pathology of endometrial carcinoma. Histopathology 62(1):111–123

    Article  PubMed  Google Scholar 

  22. Sherman ME (2000) Theories of endometrial carcinogenesis: a multidisciplinary approach. Mod Pathol 13(3):295–308

    Article  CAS  PubMed  Google Scholar 

  23. Prat J et al (2007) Endometrial carcinoma: pathology and genetics. Pathology 39(1):72–87

    Article  CAS  PubMed  Google Scholar 

  24. Armstrong AJ et al (2012) Diagnosis and management of endometrial hyperplasia. J Minim Invasive Gynecol 19(5):562–571

    Article  PubMed  Google Scholar 

  25. Gol K et al (2001) Endometrial patterns and endocrinologic characteristics of asymptomatic menopausal women. Gynecol Endocrinol 15(1):63–67

    Article  CAS  PubMed  Google Scholar 

  26. Ash SJ, Farrell SA, Flowerdew G (1996) Endometrial biopsy in DUB. J Reprod Med 41(12):892–896

    CAS  PubMed  Google Scholar 

  27. Park JC et al (2011) Endometrial histology and predictable clinical factors for endometrial disease in women with polycystic ovary syndrome. Clin Exp Reprod Med 38(1):42–46

    Article  PubMed  PubMed Central  Google Scholar 

  28. Baak JP et al (2005) The molecular genetics and morphometry-based endometrial intraepithelial neoplasia classification system predicts disease progression in endometrial hyperplasia more accurately than the 1994 World Health Organization classification system. Cancer 103(11):2304–2312

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kurman RJ, Kaminski PF, Norris HJ (1985) The behavior of endometrial hyperplasia. A long-term study of “untreated” hyperplasia in 170 patients. Cancer 56(2):403–412

    Article  CAS  PubMed  Google Scholar 

  30. Zaino RJ et al (2006) Reproducibility of the diagnosis of atypical endometrial hyperplasia: a Gynecologic Oncology Group study. Cancer 106(4):804–811

    Article  PubMed  Google Scholar 

  31. Salman MC et al (2010) Comparison of WHO and endometrial intraepithelial neoplasia classifications in predicting the presence of coexistent malignancy in endometrial hyperplasia. J Gynecol Oncol 21(2):97–101

    Article  PubMed  PubMed Central  Google Scholar 

  32. Elwood JM et al (1977) Epidemiology of endometrial cancer. J Natl Cancer Inst 59(4):1055–1060

    Article  CAS  PubMed  Google Scholar 

  33. The Writing Group for the PEPI Trial (1996) Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 275(5):370–375

    Article  Google Scholar 

  34. Herrinton LJ, Weiss NS (1993) Postmenopausal unopposed estrogens. Characteristics of use in relation to the risk of endometrial carcinoma. Ann Epidemiol 3(3):308–318

    Article  CAS  PubMed  Google Scholar 

  35. Archer DF (2001) The effect of the duration of progestin use on the occurrence of endometrial cancer in postmenopausal women. Menopause 8(4):245–251

    Article  CAS  PubMed  Google Scholar 

  36. Pike MC et al (1997) Estrogen-progestin replacement therapy and endometrial cancer. J Natl Cancer Inst 89(15):1110–1116

    Article  CAS  PubMed  Google Scholar 

  37. Anderson GL et al (2003) Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: the Women’s Health Initiative randomized trial. JAMA 290(13):1739–1748

    Article  CAS  PubMed  Google Scholar 

  38. Mourits MJ et al (2001) Tamoxifen treatment and gynecologic side effects: a review. Obstet Gynecol 97(5 Pt 2):855–866

    CAS  PubMed  Google Scholar 

  39. Killackey MA, Hakes TB, Pierce VK (1985) Endometrial adenocarcinoma in breast cancer patients receiving antiestrogens. Cancer Treat Rep 69(2):237–238

    CAS  PubMed  Google Scholar 

  40. Iqbal J et al (2012) Endometrial cancer and venous thromboembolism in women under age 50 who take tamoxifen for prevention of breast cancer: a systematic review. Cancer Treat Rev 38(4):318–328

    Article  CAS  PubMed  Google Scholar 

  41. Early Breast Cancer Trialists’ Collaborative G et al (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–784

    Article  CAS  Google Scholar 

  42. Committee on Practice B.-G. (2012) ACOG practice bulletin no. 126: Management of gynecologic issues in women with breast cancer. Obstet Gynecol 119(3):666–682

    Article  Google Scholar 

  43. Zeleniuch-Jacquotte A et al (2001) Postmenopausal endogenous oestrogens and risk of endometrial cancer: results of a prospective study. Br J Cancer 84(7):975–981

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Lukanova A et al (2004) Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women. Int J Cancer 108(3):425–432

    Article  CAS  PubMed  Google Scholar 

  45. Hardiman P, Pillay OC, Atiomo W (2003) Polycystic ovary syndrome and endometrial carcinoma. Lancet 361(9371):1810–1812

    Article  PubMed  Google Scholar 

  46. Gadducci A et al (2005) Polycystic ovary syndrome and gynecological cancers: is there a link? Gynecol Endocrinol 20(4):200–208

    Article  PubMed  Google Scholar 

  47. Giudice LC (2006) Endometrium in PCOS: Implantation and predisposition to endocrine CA. Best Pract Res Clin Endocrinol Metab 20(2):235–244

    Article  CAS  PubMed  Google Scholar 

  48. Brinton LA et al (1992) Reproductive, menstrual, and medical risk factors for endometrial cancer: results from a case-control study. Am J Obstet Gynecol 167(5):1317–1325

    Article  CAS  PubMed  Google Scholar 

  49. Xu WH et al (2004) Menstrual and reproductive factors and endometrial cancer risk: Results from a population-based case-control study in urban Shanghai. Int J Cancer 108(4):613–619

    Article  CAS  PubMed  Google Scholar 

  50. Zhang Y et al (2010) The association between metabolic abnormality and endometrial cancer: a large case-control study in China. Gynecol Oncol 117(1):41–46

    Article  CAS  PubMed  Google Scholar 

  51. Noto H et al (2010) Substantially increased risk of cancer in patients with diabetes mellitus: a systematic review and meta-analysis of epidemiologic evidence in Japan. J Diabetes Complications 24(5):345–353

    Article  PubMed  Google Scholar 

  52. Soliman PT et al (2006) Association between adiponectin, insulin resistance, and endometrial cancer. Cancer 106(11):2376–2381

    Article  CAS  PubMed  Google Scholar 

  53. Friberg E et al (2007) Diabetes mellitus and risk of endometrial cancer: a meta-analysis. Diabetologia 50(7):1365–1374

    Article  CAS  PubMed  Google Scholar 

  54. Vrachnis N et al (2016) Diabetes mellitus and gynecologic cancer: molecular mechanisms, epidemiological, clinical and prognostic perspectives. Arch Gynecol Obstet 293(2):239–246

    Article  CAS  PubMed  Google Scholar 

  55. Potischman N et al (1996) Reversal of relation between body mass and endogenous estrogen concentrations with menopausal status. J Natl Cancer Inst 88(11):756–758

    Article  CAS  PubMed  Google Scholar 

  56. Renehan AG et al (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371(9612):569–578

    Article  PubMed  Google Scholar 

  57. Pellerin GP, Finan MA (2005) Endometrial cancer in women 45 years of age or younger: a clinicopathological analysis. Am J Obstet Gynecol 193(5):1640–1644

    Article  PubMed  Google Scholar 

  58. Bharati R et al (2014) Does risk of endometrial cancer for women without a germline mutation in a DNA mismatch repair gene depend on family history of endometrial cancer or colorectal cancer? Gynecol Oncol 133(2):287–292

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Kitson SJ, Evans DG, Crosbie EJ (2017) Identifying high-risk women for endometrial cancer prevention strategies: proposal of an endometrial cancer risk prediction model. Cancer Prev Res (Phila) 10(1):1–13

    Article  Google Scholar 

  60. Hampel H (2014) NCCN increases the emphasis on genetic/familial high-risk assessment in colorectal cancer. J Natl Compr Canc Netw 12(5 Suppl):829–831

    Article  PubMed  Google Scholar 

  61. Bonadona V et al (2011) Cancer risks associated with germline mutations in MLH1, MSH2, and MSH6 genes in Lynch syndrome. JAMA 305(22):2304–2310

    Article  CAS  PubMed  Google Scholar 

  62. Elmasry K et al (2009) Strategies for endometrial screening in the Lynch syndrome population: a patient acceptability study. Fam Cancer 8(4):431–439

    Article  CAS  PubMed  Google Scholar 

  63. Lu KH, Broaddus RR (2005) Gynecologic cancers in lynch syndrome/HNPCC. Fam Cancer 4(3):249–254

    Article  PubMed  Google Scholar 

  64. Sehgal R et al (2014) Lynch syndrome: an updated review. Genes (Basel) 5(3):497–507

    Google Scholar 

  65. Vasen HF et al (1999) New clinical criteria for hereditary nonpolyposis colorectal cancer (HNPCC, Lynch syndrome) proposed by the International Collaborative group on HNPCC. Gastroenterology 116(6):1453–1456

    Article  CAS  PubMed  Google Scholar 

  66. Umar A et al (2004) Revised Bethesda Guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 96(4):261–268

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Tzortzatos G et al (2015) The gynecological surveillance of women with Lynch syndrome in Sweden. Gynecol Oncol

  68. Riegert-Johnson DL et al (2010) Cancer and Lhermitte-Duclos disease are common in Cowden syndrome patients. Hered Cancer Clin Pract 8(1):6

    Article  PubMed  PubMed Central  Google Scholar 

  69. Cheng TH et al (2016) Five endometrial cancer risk loci identified through genome-wide association analysis. Nat Genet 48(6):667–674

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Painter JN et al (2015) Fine-mapping of the HNF1B multicancer locus identifies candidate variants that mediate endometrial cancer risk. Hum Mol Genet 24(5):1478–1492

    Article  CAS  PubMed  Google Scholar 

  71. Thompson DJ et al (2016) CYP19A1 fine-mapping and Mendelian randomization: estradiol is causal for endometrial cancer. Endocr Relat Cancer 23(2):77–91

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Fraser IS et al (2007) A process designed to lead to international agreement on terminologies and definitions used to describe abnormalities of menstrual bleeding. Fertil Steril 87(3):466–476

    Article  PubMed  Google Scholar 

  73. American College of O. and Gynecologists (2005) ACOG practice bulletin, clinical management guidelines for obstetrician-gynecologists, number 65, August 2005: management of endometrial cancer. Obstet Gynecol 106(2):413–425

    Article  Google Scholar 

  74. Seebacher V et al (2009) The presence of postmenopausal bleeding as prognostic parameter in patients with endometrial cancer: a retrospective multi-center study. BMC Cancer 9:460

    Article  PubMed  PubMed Central  Google Scholar 

  75. Committee on Practice B.-G. (2013) Practice bulletin no. 136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstet Gynecol 122(1):176–185

    Article  Google Scholar 

  76. Haidopoulos D et al (2010) Risk factors in women 40 years of age and younger with endometrial carcinoma. Acta Obstet Gynecol Scand 89(10):1326–1330

    Article  PubMed  Google Scholar 

  77. Smith-Bindman R, Weiss E, Feldstein V (2004) How thick is too thick? When endometrial thickness should prompt biopsy in postmenopausal women without vaginal bleeding. Ultrasound Obstet Gynecol 24(5):558–565

    Article  CAS  PubMed  Google Scholar 

  78. Osmers R et al (1989) Vaginosonographic measurement of the postmenopausal endometrium in the early detection of endometrial cancer. Geburtshilfe Frauenheilkd 49(3):262–265

    Article  CAS  PubMed  Google Scholar 

  79. Seckin B et al (2016) Diagnostic value of sonography for detecting endometrial pathologies in postmenopausal women with and without bleeding. J Clin Ultrasound

  80. Timmermans A et al (2010) Endometrial thickness measurement for detecting endometrial cancer in women with postmenopausal bleeding: a systematic review and meta-analysis. Obstet Gynecol 116(1):160–167

    Article  PubMed  Google Scholar 

  81. Bouzid A, Ayachi A, Mourali M (2015) Value of ultrasonography to predict the endometrial cancer in postmenopausal bleeding. Gynecol Obstet Fertil 43(10):652–658

    Article  CAS  PubMed  Google Scholar 

  82. Sladkevicius P, Valentin L (2016) Prospective validation of two mathematical models to calculate the risk of endometrial malignancy in patients with postmenopausal bleeding and sonographic endometrial thickness ≥4.5 mm. Eur J Cancer 59:179–188

    Article  PubMed  Google Scholar 

  83. Anastasiadis PG et al (2000) Endometrial polyps: prevalence, detection, and malignant potential in women with abnormal uterine bleeding. Eur J Gynaecol Oncol 21(2):180–183

    CAS  PubMed  Google Scholar 

  84. Dreisler E et al (2009) Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20–74 years. Ultrasound Obstet Gynecol 33(1):102–108

    Article  CAS  PubMed  Google Scholar 

  85. Dreisler E et al (2009) Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding. Ultrasound Obstet Gynecol 33(3):344–348

    Article  CAS  PubMed  Google Scholar 

  86. Lieng M et al (2008) Flow differences between endometrial polyps and cancer: a prospective study using intravenous contrast-enhanced transvaginal color flow Doppler and three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 32(7):935–940

    Article  CAS  PubMed  Google Scholar 

  87. Perez-Medina T et al (2002) Predicting atypia inside endometrial polyps. J Ultrasound Med 21(2):125–128

    Article  PubMed  Google Scholar 

  88. Lieng M, Istre O, Qvigstad E (2010) Treatment of endometrial polyps: a systematic review. Acta Obstet Gynecol Scand 89(8):992–1002

    Article  PubMed  Google Scholar 

  89. Fischerova D, Cibula D (2015) Ultrasound in gynecological cancer: is it time for re-evaluation of its uses? Curr Oncol Rep 17(6):28

    Article  PubMed  Google Scholar 

  90. Fischerova D (2011) Ultrasound scanning of the pelvis and abdomen for staging of gynecological tumors: a review. Ultrasound Obstet Gynecol 38(3):246–266

    Article  CAS  PubMed  Google Scholar 

  91. Wang Y et al (2014) Time-intensity curve parameters in rectal cancer measured using endorectal ultrasonography with sterile coupling gels filling the rectum: correlations with tumor angiogenesis and clinicopathological features. Biomed Res Int 2014:587806

    PubMed  PubMed Central  Google Scholar 

  92. Liu Y et al (2016) Quantitative contrast-enhanced ultrasonography for the differential diagnosis of endometrial hyperplasia and endometrial neoplasms. Oncol Lett 12(5):3763–3770

    PubMed  PubMed Central  Google Scholar 

  93. Kierans AS et al (2014) Utility of conventional and diffusion-weighted MRI features in distinguishing benign from malignant endometrial lesions. Eur J Radiol 83(4):726–732

    Article  PubMed  Google Scholar 

  94. Shen SH et al (2008) Diffusion-weighted single-shot echo-planar imaging with parallel technique in assessment of endometrial cancer. AJR Am J Roentgenol 190(2):481–488

    Article  PubMed  Google Scholar 

  95. Takeuchi M et al (2005) Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging. Eur Radiol 15(11):2244–2255

    Article  PubMed  Google Scholar 

  96. Fujii S et al (2008) Diagnostic accuracy of the apparent diffusion coefficient in differentiating benign from malignant uterine endometrial cavity lesions: initial results. Eur Radiol 18(2):384–389

    Article  PubMed  Google Scholar 

  97. Wang J et al (2010) The value of the apparent diffusion coefficient in differentiating stage IA endometrial carcinoma from normal endometrium and benign diseases of the endometrium: initial study at 3-T magnetic resonance scanner. J Comput Assist Tomogr 34(3):332–337

    Article  PubMed  Google Scholar 

  98. Takeuchi M, Matsuzaki K, Nishitani H (2009) Diffusion-weighted magnetic resonance imaging of endometrial cancer: differentiation from benign endometrial lesions and preoperative assessment of myometrial invasion. Acta Radiol 50(8):947–953

    Article  CAS  PubMed  Google Scholar 

  99. Bakir B et al (2017) Role of diffusion weighted MRI in the differential diagnosis of endometrial cancer, polyp, hyperplasia, and physiological thickening. Clin Imaging 41:86–94

    Article  PubMed  Google Scholar 

  100. Lai CR, Hsu CY, Li AF (2012) Degenerative necrotic endometrial debris in Papanicolaou smears. The role in the prediction of endometrial pathology. Am J Clin Pathol 137(2):290–294

    Article  PubMed  Google Scholar 

  101. Zhou J, Tomashefski J Jr, Khiyami A (2007) Diagnostic value of the thin-layer, liquid-based Pap test in endometrial cancer: a retrospective study with emphasis on cytomorphologic features. Acta Cytol 51(5):735–741

    Article  PubMed  Google Scholar 

  102. Kir G et al (2014) Significance of foamy histiocytes in cervical smears from postmenopausal women. Acta Cytol 58(1):42–46

    Article  PubMed  Google Scholar 

  103. Schnatz PF et al (2006) Clinical significance of atypical glandular cells on cervical cytology. Obstet Gynecol 107(3):701–708

    Article  PubMed  Google Scholar 

  104. Gu M et al (2001) Pap smears in women with endometrial carcinoma. Acta Cytol 45(4):555–560

    Article  CAS  PubMed  Google Scholar 

  105. Sams SB, Currens HS, Raab SS (2012) Liquid-based Papanicolaou tests in endometrial carcinoma diagnosis. Performance, error root cause analysis, and quality improvement. Am J Clin Pathol 137(2):248–254

    Article  PubMed  Google Scholar 

  106. Serdy K et al (2016) The Value of papanicolaou tests in the diagnosis of endometrial carcinoma: a large study cohort from an Academic Medical Center. Am J Clin Pathol 145(3):350–354

    Article  CAS  PubMed  Google Scholar 

  107. Levine L, Lucci JA 3rd, Dinh TV (2003) Atypical glandular cells: new Bethesda Terminology and Management Guidelines. Obstet Gynecol Surv 58(6):399–406

    PubMed  Google Scholar 

  108. Wright TC Jr et al (2007) 2006 consensus guidelines for the management of women with abnormal cervical screening tests. J Low Genit Tract Dis 11(4):201–222

    Article  PubMed  Google Scholar 

  109. Sanam M, Majid MM (2015) Comparison the diagnostic value of dilatation and curettage versus endometrial biopsy by Pipelle: a clinical trial. Asian Pac J Cancer Prev 16(12):4971–4975

    Article  PubMed  Google Scholar 

  110. Fakhar S et al (2008) Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding. Ann Saudi Med 28(3):188–191

    Article  PubMed  Google Scholar 

  111. Abdelazim IA, Aboelezz A, Abdulkareem AF (2013) Pipelle endometrial sampling versus conventional dilatation and curettage in patients with abnormal uterine bleeding. J Turk Ger Gynecol Assoc 14(1):1–5

    Article  PubMed  PubMed Central  Google Scholar 

  112. Abdelazim IA et al (2015) Accuracy of endometrial sampling compared to conventional dilatation and curettage in women with abnormal uterine bleeding. Arch Gynecol Obstet 291(5):1121–1126

    Article  PubMed  Google Scholar 

  113. Guido RS et al (1995) Pipelle endometrial sampling. Sensitivity in the detection of endometrial cancer. J Reprod Med 40(8):553–555

    CAS  PubMed  Google Scholar 

  114. Goldstein SR (2010) Modern evaluation of the endometrium. Obstet Gynecol 116(1):168–176

    Article  PubMed  Google Scholar 

  115. Epstein E et al (2001) Dilatation and curettage fails to detect most focal lesions in the uterine cavity in women with postmenopausal bleeding. Acta Obstet Gynecol Scand 80(12):1131–1136

    Article  CAS  PubMed  Google Scholar 

  116. Gebauer G et al (2001) Role of hysteroscopy in detection and extraction of endometrial polyps: results of a prospective study. Am J Obstet Gynecol 184(2):59–63

    Article  CAS  PubMed  Google Scholar 

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TT: manuscript writing, RK: manuscript editing, AY: manuscript editing.

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Correspondence to Tamar Tzur.

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Tzur, T., Kessous, R. & Weintraub, A.Y. Current strategies in the diagnosis of endometrial cancer. Arch Gynecol Obstet 296, 5–14 (2017). https://doi.org/10.1007/s00404-017-4391-z

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